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NPI Code Detail

MEDICARE: MS. DEBORAH ANNE BOMBARD PA-C

MEDICARE: MS. DEBORAH ANNE BOMBARD PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA207DC

General Provider Information

NPI Number : 1043420888
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORAH ANNE BOMBARD PA-C
Provider Business Mailing Address
First Line : 205 W GLENDALE AVE
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22301-2452
Country : US
Telephone Number : 703-548-0942
Fax Number :
Provider Business Practice Location Address
First Line : 2831 15TH ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20009-4607
Country : US
Telephone Number : 202-462-4788
Fax Number : 202-667-3706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 07/08/2007

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Directions to “ MS. DEBORAH ANNE BOMBARD PA-C” Practice Location

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