Healthcare Provider Details

I. General information

NPI: 1851527766
Provider Name (Legal Business Name): MATTHEW DEBIEC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-5763
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-4504
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-0408
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number14240
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: