Provider Demographics
NPI:1992388219
Name:ADEBAMOWO, DEBORAH OLUFUNMILAYO (MD)
Entity type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:OLUFUNMILAYO
Last Name:ADEBAMOWO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:111 CHAMBERS HILL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-7304
Mailing Address - Country:US
Mailing Address - Phone:717-709-7922
Mailing Address - Fax:717-263-2055
Practice Address - Street 1:820 5TH AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4219
Practice Address - Country:US
Practice Address - Phone:717-709-7922
Practice Address - Fax:717-263-2055
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2024-07-18
Deactivation Date:2023-03-23
Deactivation Code:
Reactivation Date:2023-04-20
Provider Licenses
StateLicense IDTaxonomies
PAMT223602207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine