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General NPI Number Information
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NPI Number | 1164609814
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Entity Type | Individual
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Provider Name | NOSHIR E DEBOO MD
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Gender | Male
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 140 WEST MAIN STREET SUITE 100
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City | SPRINGFIELD
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State | OH
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Zip | 45502
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Country | US
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Telephone | 937-398-1066
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Fax | 937-398-1076
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Provider Business Mailing Address
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Address Line | 140 W MAIN ST
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City | SPRINGFIELD
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State | OH
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Zip | 45502-1312
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Country | US
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Telephone | 937-398-1066
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Fax | 937-398-1076
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 38443
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License Number State | OH
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