Individual
MRS. DEBORAH ANNE SPOONER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-0957
Mailing address
7837 DEBOY AVE, DUNDALK, MD 21222-2719
(410) 328-0957
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C01199
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01199
PHYSICIAN ASST LICENSE#
MD
Enumeration date
05/08/2007
Last updated
07/08/2007
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