Provider Demographics
NPI:1790796522
Name:DURBIN, MARY BETH (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:BETH
Last Name:DURBIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:15301 WARREN SHINGLE RD
Mailing Address - Street 2:
Mailing Address - City:BEALE AFB
Mailing Address - State:CA
Mailing Address - Zip Code:95903-1907
Mailing Address - Country:US
Mailing Address - Phone:530-634-4750
Mailing Address - Fax:530-634-4763
Practice Address - Street 1:15301 WARREN SHINGLE RD
Practice Address - Street 2:
Practice Address - City:BEALE AFB
Practice Address - State:CA
Practice Address - Zip Code:95903-1907
Practice Address - Country:US
Practice Address - Phone:530-634-4750
Practice Address - Fax:530-634-4763
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2017-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME1743207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine