Healthcare Provider Details

I. General information

NPI: 1942343660
Provider Name (Legal Business Name): DEBBIE-ANN T. SHIRLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 08/14/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 W MAIN ST
CHARLOTTESVILLE VA
22903-2824
US

IV. Provider business mailing address

PO BOX 100296
GAINESVILLE FL
32610-0296
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-0123
  • Fax: 434-243-3300
Mailing address:
  • Phone: 352-294-5252
  • Fax: 352-294-8068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME163269
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number0101254984
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number0101254984
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberME163269
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: