Healthcare Provider Details

I. General information

NPI: 1487697876
Provider Name (Legal Business Name): DEBORAH MALTERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 05/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 GRAND AVENUE SUITE 6
BILLINGS MT
59102-6258
US

IV. Provider business mailing address

3737 GRAND AVENUE SUITE 6
BILLINGS MT
59102-6258
US

V. Phone/Fax

Practice location:
  • Phone: 406-839-2985
  • Fax: 406-839-2986
Mailing address:
  • Phone: 406-839-2985
  • Fax: 406-839-2986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number8475
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMT8475
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: