Provider Demographics
NPI:1215152103
Name:BABCOCK, DEBRA J (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:J
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6001 EXECUTIVE BLVD RM 2108
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3831
Mailing Address - Country:US
Mailing Address - Phone:301-496-9964
Mailing Address - Fax:301-402-2060
Practice Address - Street 1:6001 EXECUTIVE BLVD RM 2108
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3831
Practice Address - Country:US
Practice Address - Phone:301-496-9964
Practice Address - Fax:301-402-2060
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00590112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology