Provider Demographics
NPI:1548278021
Name:DRYER-AKL, DEBORAH A (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:A
Last Name:DRYER-AKL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7665 US HWY 2
Mailing Address - Street 2:THE LAKES COMMUNITY HEALTH CENTER
Mailing Address - City:IRON RIVER
Mailing Address - State:WI
Mailing Address - Zip Code:54847-4260
Mailing Address - Country:US
Mailing Address - Phone:715-372-5001
Mailing Address - Fax:715-372-5067
Practice Address - Street 1:7665 US HWY 2
Practice Address - Street 2:THE LAKES COMMUNITY HEALTH CENTER
Practice Address - City:IRON RIVER
Practice Address - State:WI
Practice Address - Zip Code:54847-4260
Practice Address - Country:US
Practice Address - Phone:715-372-5001
Practice Address - Fax:715-372-5067
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI45686207Q00000X
WI45686020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34414600Medicaid
WI45686OtherSTATE LICENSE
WI45686OtherSTATE LICENSE
WIH43425Medicare UPIN
WI000804100Medicare ID - Type Unspecified
WIBD7466065OtherDEA NUMBER