Individual
DEBORAH ROTH BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
110 IRVING ST NW STE NA1177, WASHINGTON, DC 20010-3017
(202) 877-4343
Mailing address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2945
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
4214
CT
363AS0400X
Surgical Physician Assistant
Primary
4214
CT
Other
Enumeration date
06/07/2017
Last updated
11/01/2020
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