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General NPI Number Information
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NPI Number | 1881620185
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Entity Type | Individual
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Provider Name | MAUREEN SHANAHAN DEBBAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6900 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20307-0003
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Country | US
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Telephone | 202-782-7289
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Fax |
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Provider Business Mailing Address
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Address Line | 4104 N GARLAND ST
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City | ALEXANDRIA
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State | VA
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Zip | 22304-1718
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Country | US
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Telephone | 703-370-4084
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101030457
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License Number State | VA
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