Healthcare Provider Details

I. General information

NPI: 1932181781
Provider Name (Legal Business Name): DEBRA ACERENZA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 THOMAS JOHNSON DR SUITE 101
FREDERICK MD
21702-4373
US

IV. Provider business mailing address

8110 MAPLE LAWN BLVD STE 235
FULTON MD
20759-2694
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-4545
  • Fax: 301-663-1709
Mailing address:
  • Phone: 301-340-8339
  • Fax: 301-340-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberH58788
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: