Healthcare Provider Details

I. General information

NPI: 1851515605
Provider Name (Legal Business Name): DEBORAH S. GELBSPAN M.D., MBA, FCAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5422 W THUNDERBIRD RD SUITE 13
GLENDALE AZ
85306-4700
US

IV. Provider business mailing address

5422 W THUNDERBIRD RD SUITE 13
GLENDALE AZ
85306-4700
US

V. Phone/Fax

Practice location:
  • Phone: 602-547-1024
  • Fax:
Mailing address:
  • Phone: 602-547-1024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number28872
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: