Provider Demographics
NPI:1386790590
Name:CRESSMAN, DEBRA ELLEN (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ELLEN
Last Name:CRESSMAN
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 1:215 N BEST AVE
Mailing Address - Street 2:
Mailing Address - City:WALNUTPORT
Mailing Address - State:PA
Mailing Address - Zip Code:18088-1204
Mailing Address - Country:US
Mailing Address - Phone:610-760-7044
Mailing Address - Fax:610-760-8587
Practice Address - Street 1:215 N BEST AVE
Practice Address - Street 2:
Practice Address - City:WALNUTPORT
Practice Address - State:PA
Practice Address - Zip Code:18088-1204
Practice Address - Country:US
Practice Address - Phone:610-760-7044
Practice Address - Fax:610-760-8587
Is Sole Proprietor?:No
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045718L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD045718LOtherSTATE LICENSE
CR118060Medicare ID - Type Unspecified
PAF38653Medicare UPIN