Individual
DR. DEBORAH R DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1815 GUNBARREL RD, CHATTANOOGA, TN 37421-3130
(423) 648-3937
(423) 648-2043
Mailing address
1815 GUNBARREL RD, CHATTANOOGA, TN 37421-3130
(423) 648-3937
(423) 648-2043
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
14067
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020153
BLUE CROSS BLUE SHIELD
TN
Enumeration date
02/13/2006
Last updated
11/28/2011
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