Provider Demographics
NPI:1710048137
Name:THOMPSON, DEBORAH M (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:5100 AUTH WAY
Practice Address - Street 2:
Practice Address - City:SULTLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4207
Practice Address - Country:US
Practice Address - Phone:301-702-5000
Practice Address - Fax:301-702-5116
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD18003207Q00000X
VA0101220816207Q00000X
MDD30296207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B62028Medicare UPIN
006570M92Medicare ID - Type Unspecified