Healthcare Provider Details

I. General information

NPI: 1467437442
Provider Name (Legal Business Name): DEBORAH D FOLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12930 WORLDGATE DR STE 300
HERNDON VA
20170-6032
US

IV. Provider business mailing address

5622 BLACKFOOT TRL
CARMEL IN
46033-2386
US

V. Phone/Fax

Practice location:
  • Phone: 703-657-5500
  • Fax:
Mailing address:
  • Phone: 719-661-7019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01070125A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: