Healthcare Provider Details

I. General information

NPI: 1417912528
Provider Name (Legal Business Name): DEBORAH SUE KUHLMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W MCGALLIARD RD
MUNCIE IN
47303-1828
US

IV. Provider business mailing address

401 W MCGALLIARD RD
MUNCIE IN
47303-1828
US

V. Phone/Fax

Practice location:
  • Phone: 765-288-6200
  • Fax: 765-288-4131
Mailing address:
  • Phone: 765-288-6200
  • Fax: 765-288-4131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number01031257A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: