Deborah Juanita Bullock, MD

Individual provider Active NPI Family Medicine Physician · Arnold, MD

NPI 1922083047 · NPPES record last updated Aug 29, 2018

Key facts

NPI
1922083047
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
D78883 (MD)
Practice address
208 Treyburn Way
Arnold, MD 21012
Phone
(443) 758-3031
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Conemaugh Health Initiatives Family Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D78883 MD Yes

Addresses

Primary practice location

208 Treyburn Way
Arnold, MD 21012

Mailing address

208 Treyburn Way
Arnold, MD 21012-2577
Phone (443) 758-3031

Other names

  • Deborah Hinkson Bullock Professional name

Other providers in Arnold, MD

All providers in Arnold, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.