Provider Demographics
NPI:1265542484
Name:GORIN, DEBRA S (MD PC)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:S
Last Name:GORIN
Suffix:
Gender:F
Credentials:MD PC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1361 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-4208
Mailing Address - Country:US
Mailing Address - Phone:208-535-8549
Mailing Address - Fax:208-528-8109
Practice Address - Street 1:1361 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-4208
Practice Address - Country:US
Practice Address - Phone:208-535-8549
Practice Address - Fax:208-528-8109
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME485012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry