Provider Demographics
NPI:1386757375
Name:ALSPECTOR, DEBRA ANNE (MD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANNE
Last Name:ALSPECTOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 SCIO RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-9716
Mailing Address - Country:US
Mailing Address - Phone:716-251-2858
Mailing Address - Fax:
Practice Address - Street 1:15400 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3724
Practice Address - Country:US
Practice Address - Phone:313-416-6215
Practice Address - Fax:313-221-9799
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD456907207Q00000X
NY262215207Q00000X
FLME126661207Q00000X
IN01076307A207Q00000X
RIMD15240207Q00000X
MDD80957207Q00000X
MEMD20938207Q00000X
VT042.0013465207Q00000X
CT55062207Q00000X
NJ25MA09945900207Q00000X
GA077043207Q00000X
MA267139207Q00000X
CAA65622207Q00000X
AZ51160207Q00000X
MI4301075441207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH12401Medicare UPIN
MI0N85820Medicare ID - Type Unspecified