Provider Demographics
NPI:1891778395
Name:SMITH, DEBORAH E (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:SMITH
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 1:30 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2052
Mailing Address - Country:US
Mailing Address - Phone:413-582-2900
Mailing Address - Fax:413-923-9322
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2052
Practice Address - Country:US
Practice Address - Phone:413-582-2900
Practice Address - Fax:413-923-9322
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA47704207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ02450OtherBCBSMA
MA110063758AMedicaid
MA6751OtherBMC
MA7848046OtherAETNA
MA047704OtherTUFTS
MA19014OtherHEALTH NEW ENGLAND
MA110063758AMedicaid
MAS4002522472Medicare PIN
MA6166415Medicaid
MA2359417OtherAETNA
MAJ02450OtherBCBSMA