Provider Demographics
NPI:1962526848
Name:GREENWALL, DEBORAH LOUISE (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LOUISE
Last Name:GREENWALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:914 RUTHERFORD WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4761
Mailing Address - Country:US
Mailing Address - Phone:303-471-9068
Mailing Address - Fax:720-344-2843
Practice Address - Street 1:125 INVERNESS DR E
Practice Address - Street 2:SUITE 200
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5137
Practice Address - Country:US
Practice Address - Phone:303-503-6315
Practice Address - Fax:303-649-9694
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30577174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist