Provider Demographics
NPI:1811992613
Name:DEBIEC, HENRY D (DO)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:D
Last Name:DEBIEC
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:440-293-2444
Mailing Address - Fax:440-293-2445
Practice Address - Street 1:5594 STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:OH
Practice Address - Zip Code:44003-9490
Practice Address - Country:US
Practice Address - Phone:440-293-2444
Practice Address - Fax:440-293-2445
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-006357L208D00000X
OH34004454208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0746376Medicaid
PA0015748660006Medicaid
OH0746376Medicaid
OHE29610Medicare UPIN
PA0015748660006Medicaid