Provider Demographics
NPI:1801953062
Name:MAGER, DEBORAH A (DC,)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:MAGER
Suffix:
Gender:F
Credentials:DC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 ELLIOTT ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3205
Mailing Address - Country:US
Mailing Address - Phone:978-922-1730
Mailing Address - Fax:978-922-9664
Practice Address - Street 1:139 ELLIOTT ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-3205
Practice Address - Country:US
Practice Address - Phone:978-922-1730
Practice Address - Fax:978-922-9664
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA524111NN0400X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD44-00362OtherUNITED HEALTHCARE
MA1613243Medicaid
MA20819101OtherCIGNA HEALTHCARE
MA712354OtherTUFTS HEALTHCARE
MA71650OtherAETNA
MAY35347OtherBC BS OF MA
MA350051094Medicare ID - Type UnspecifiedPALMETTO GBA RAILROAD
MAY35347OtherBC BS OF MA