Healthcare Provider Details

I. General information

NPI: 1336175876
Provider Name (Legal Business Name): DEBORAH DUNN DRODER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH DUNN HANSEN M.D.

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4623 WESLEY AVE SUITE P
CINCINNATI OH
45212-2246
US

IV. Provider business mailing address

935 STATE ROUTE 28
MILFORD OH
45150-1911
US

V. Phone/Fax

Practice location:
  • Phone: 513-841-0777
  • Fax: 513-742-0597
Mailing address:
  • Phone: 513-831-5955
  • Fax: 513-831-5985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number35-04-6429
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301047227
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number7307
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberTP440
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: