Provider Demographics
NPI:1821100694
Name:WALSHAW, DEBRA L (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:L
Last Name:WALSHAW
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 1:3945 E PARADISE FALLS DRIVE
Mailing Address - Street 2:STE. 201
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6687
Mailing Address - Country:US
Mailing Address - Phone:520-615-6200
Mailing Address - Fax:520-615-6255
Practice Address - Street 1:3945 E PARADISE FALLS DRIVE
Practice Address - Street 2:STE. 201
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6687
Practice Address - Country:US
Practice Address - Phone:520-615-6200
Practice Address - Fax:520-615-6255
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28605207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ597809Medicaid
AZ597809Medicaid
AZZ66322Medicare UPIN
AZ597809Medicaid