Healthcare Provider Details

I. General information

NPI: 1144200585
Provider Name (Legal Business Name): DEBORAH F BILLMIRE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 11/27/2023
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 RILEY HOSPITAL DR STE 2500
INDIANAPOLIS IN
46202-5109
US

IV. Provider business mailing address

705 RILEY HOSPITAL DR STE 2500
INDIANAPOLIS IN
46202-5109
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-4681
  • Fax: 317-274-4491
Mailing address:
  • Phone: 317-274-4681
  • Fax: 317-274-4491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number01053289A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: