Provider Demographics
NPI:1679675664
Name:SPITZ, DEBORAH FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:FRANCIS
Last Name:SPITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 WASHINGTON ST
Mailing Address - Street 2:MEZZANINE LEVEL
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6219
Mailing Address - Country:US
Mailing Address - Phone:781-237-3412
Mailing Address - Fax:781-235-6786
Practice Address - Street 1:332 WASHINGTON ST
Practice Address - Street 2:MEZZANINE LEVEL
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-6219
Practice Address - Country:US
Practice Address - Phone:781-237-3412
Practice Address - Fax:781-235-6786
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52765174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3014452Medicaid
MAJ05898Medicare PIN