Healthcare Provider Details

I. General information

NPI: 1437135613
Provider Name (Legal Business Name): DEBORAH M ARCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH MCGREGOR

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 BENT WAY
LONGMONT CO
80503-7614
US

IV. Provider business mailing address

10350 E DAKOTA AVE
DENVER CO
80247-1314
US

V. Phone/Fax

Practice location:
  • Phone: 303-338-4545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0043443
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number43443
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: