Provider Demographics
NPI:1932180643
Name:DELL, DEBORAH ANN (DO)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANN
Last Name:DELL
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:601 S SHORE DR
Mailing Address - Street 2:STE 329
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4440
Mailing Address - Country:US
Mailing Address - Phone:269-969-6212
Mailing Address - Fax:269-969-6224
Practice Address - Street 1:601 S SHORE DR
Practice Address - Street 2:STE 329
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4440
Practice Address - Country:US
Practice Address - Phone:269-969-6212
Practice Address - Fax:269-969-6224
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2011-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101010721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI440973011Medicaid
F24500Medicare UPIN
MI440973011Medicaid