Provider Demographics
NPI:1891808135
Name:REED, DEBORAH ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ANN
Last Name:REED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:ELYADERANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4001 CARRICK DR STE 170
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5392
Mailing Address - Country:US
Mailing Address - Phone:330-721-8594
Mailing Address - Fax:440-442-6087
Practice Address - Street 1:4001 CARRICK DR STE 170
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5392
Practice Address - Country:US
Practice Address - Phone:330-721-8594
Practice Address - Fax:440-442-6087
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-7294-R2084P2900X, 2084N0400X, 261QP3300X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2256008Medicaid
OH2256008Medicaid
OHRE4057409Medicare ID - Type Unspecified