Provider Demographics
NPI:1528021466
Name:WAY, DEBORAH (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:WAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 WINDING DR
Mailing Address - Street 2:MONROE OFFICE CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-2907
Mailing Address - Country:US
Mailing Address - Phone:215-581-2046
Mailing Address - Fax:215-473-5047
Practice Address - Street 1:1 WINDING DR
Practice Address - Street 2:MONROE OFFICE CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2907
Practice Address - Country:US
Practice Address - Phone:215-581-2046
Practice Address - Fax:215-473-5047
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425783207RG0300X, 207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI28862Medicare UPIN