Individual
MS. DEBORAH ANNE SURFACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
431 BOYD CIR, MICHIGAN CITY, IN 46360-7022
(219) 873-3696
(219) 872-1938
Mailing address
431 BOYD CIR, MICHIGAN CITY, IN 46360-7022
(219) 873-3696
(219) 872-1938
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056008095
IL
225X00000X
Occupational Therapist
Primary
310000932A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000095746
BLUE CROSS BLUE SHIELD
IN
01
—
09932114
BCBS
IL
05
—
200043890
—
IN
05
—
200655000
—
IN
05
—
2007148410A
—
IN
01
—
2187460
UNITED HEALTHCARE
IN
Enumeration date
12/02/2006
Last updated
04/29/2008
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