Provider Demographics
NPI:1184692592
Name:BITTAR, DEBORAH GISRIEL (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:GISRIEL
Last Name:BITTAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:515 FAIRMOUNT AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5466
Mailing Address - Country:US
Mailing Address - Phone:410-494-1369
Mailing Address - Fax:410-494-2737
Practice Address - Street 1:849 FAIRMONT AVENUE
Practice Address - Street 2:SUITE 100A
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2600
Practice Address - Country:US
Practice Address - Phone:410-494-1369
Practice Address - Fax:494-273-7410
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2018-12-26
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Provider Licenses
StateLicense IDTaxonomies
MDD0031446208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE32838Medicare UPIN