Provider Demographics
NPI:1356397541
Name:MULLEY, DEBRA A (MD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:MULLEY
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 1:1493 CAMBRIDGE STREET.
Mailing Address - Street 2:CAMBRIDGE HEALTH ALLIANCE
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139
Mailing Address - Country:US
Mailing Address - Phone:617-665-1566
Mailing Address - Fax:
Practice Address - Street 1:1493 CAMBRIDGE STREET.
Practice Address - Street 2:CAMBRIDGE HEALTH ALLIANCE
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139
Practice Address - Country:US
Practice Address - Phone:617-665-1566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209128207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery