Provider Demographics
NPI:1629032024
Name:MENZIE, DEBORAH K (MD)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:K
Last Name:MENZIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:K
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:88 OSBORNE ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4146
Mailing Address - Country:US
Mailing Address - Phone:814-474-6454
Mailing Address - Fax:814-509-6332
Practice Address - Street 1:88 OSBORNE ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4146
Practice Address - Country:US
Practice Address - Phone:814-474-6454
Practice Address - Fax:814-509-6332
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009404207Q00000X
PAOS009404L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01607232Medicaid
PA181482Medicare ID - Type Unspecified
PA01607232Medicaid