Healthcare Provider Details

I. General information

NPI: 1891808135
Provider Name (Legal Business Name): DEBORAH ANN REED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH ANN ELYADERANI M.D.

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 12/28/2020
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 CARRICK DR STE 170
MEDINA OH
44256-5392
US

IV. Provider business mailing address

4001 CARRICK DR STE 170
MEDINA OH
44256-5392
US

V. Phone/Fax

Practice location:
  • Phone: 330-721-8594
  • Fax: 440-442-6087
Mailing address:
  • Phone: 330-721-8594
  • Fax: 440-442-6087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number35-07-7294-R
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35-07-7294-R
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: