Provider Demographics
NPI:1336175876
Name:DRODER, DEBORAH DUNN (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:DUNN
Last Name:DRODER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:DUNN
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:935 STATE ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1911
Mailing Address - Country:US
Mailing Address - Phone:513-831-5955
Mailing Address - Fax:513-831-5985
Practice Address - Street 1:4623 WESLEY AVE
Practice Address - Street 2:SUITE P
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2246
Practice Address - Country:US
Practice Address - Phone:513-841-0777
Practice Address - Fax:513-742-0597
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-6429208D00000X
MI4301047227208D00000X
HI7307208D00000X
KYTP440208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHHA4167167Medicare ID - Type UnspecifiedDUCO FAIRBORN
OHHA4167164Medicare ID - Type UnspecifiedDUCO KETTERING
OHHA4167165Medicare ID - Type UnspecifiedDUCO DAYTON
OHHA4167162Medicare ID - Type UnspecifiedDUCO MILFORD
OHE37441Medicare UPIN
OHHA4167161Medicare ID - Type UnspecifiedDUCO SPRINGDALE
OHHA4167166Medicare ID - Type UnspecifiedDUCO COLERAIN
OHHA4167163Medicare ID - Type UnspecifiedDUCO MIDDLETOWN/FRANKLIN