Provider Demographics
NPI:1750315818
Name:BARBEAU, DEBORAH NICOLLS (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:NICOLLS
Last Name:BARBEAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:JEAN
Other - Last Name:NICOLLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 MOUNT ROYAL AVE
Mailing Address - Street 2:#50
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-1981
Mailing Address - Country:US
Mailing Address - Phone:508-251-7260
Mailing Address - Fax:508-251-7265
Practice Address - Street 1:5 MOUNT ROYAL AVE
Practice Address - Street 2:#50
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-1981
Practice Address - Country:US
Practice Address - Phone:508-251-7260
Practice Address - Fax:508-251-7265
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052796207RI0200X
LAMD.202051207RI0200X
MA267760207RI0200X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease