Debra Gulyanics, DO

Individual provider Active NPI Family Medicine Physician · Chesterfield, IN

NPI 1376597302 · NPPES record last updated Oct 29, 2019

Key facts

NPI
1376597302
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
02003656A (IN)
Practice address
307 Western Dr
Chesterfield, IN 46017-1230
Phone
(928) 566-7460
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Internal Medicine Associates PC Past Accepting new patients
Tizon Emergency Associates, PLLC Emergency Medicine Past Accepting new patients
London Bridge Emergency Physicians Emergency Medicine Past Accepting new patients
Havasu Emergency Physicians, PC Emergency Medicine Past
since Jun 1, 1998
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 3054 AZ
Family Medicine Physician 207Q00000X 3054 AZ
Family Medicine Physician 207Q00000X 02003656A IN Yes

Addresses

Primary practice location

307 Western Dr
Chesterfield, IN 46017-1230

Mailing address

307 Western Dr
Chesterfield, IN 46017-1230

Other identifiers

IdentifierTypeStateIssuer
326547MedicaidAZ
100223740MedicaidIN
P01723956OtherINRR MEDICARE

Other providers in Chesterfield, IN

All providers in Chesterfield, IN · Family Medicine Physician in Indiana

Sources for this page

Verify at the official NPI Registry.