Provider Demographics
NPI:1841409778
Name:DOWDEN, DEBORAH L (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:L
Last Name:DOWDEN
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 1:5494 BROWN RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-1100
Mailing Address - Country:US
Mailing Address - Phone:314-731-0200
Mailing Address - Fax:314-731-0204
Practice Address - Street 1:5494 BROWN RD
Practice Address - Street 2:SUITE105
Practice Address - City:HAZELWOOD
Practice Address - State:MO
Practice Address - Zip Code:63042-1100
Practice Address - Country:US
Practice Address - Phone:314-731-0200
Practice Address - Fax:314-731-0204
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD-R2K61174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOE38718Medicare UPIN