1538287701 NPI number — DR. DEBORAH LAUTH TUSSING DEBORAH TUSSING. M.D

Table of content: DR. DEBORAH LAUTH TUSSING DEBORAH TUSSING. M.D (NPI 1538287701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538287701 NPI number — DR. DEBORAH LAUTH TUSSING DEBORAH TUSSING. M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TUSSING
Provider First Name:
DEBORAH
Provider Middle Name:
LAUTH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DEBORAH TUSSING. M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TUSSING
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DEBORAH TUSSING
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1538287701
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
670 HENDLER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEVERNA PARK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21146-3618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-507-5277
Provider Business Mailing Address Fax Number:
410-647-6321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
670 HENDLER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEVERNA PARK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21146-3618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-507-5277
Provider Business Practice Location Address Fax Number:
410-647-6321
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  D33500 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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