Basic Information
| Provider Information | |||||||||
| NPI: | 1699775056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONRAN | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31516 WINTERPLACE PKWY | ||||||||
| Address2: | STE 103 | ||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218042417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103346351 | ||||||||
| FaxNumber: | 4103346352 | ||||||||
| Practice Location | |||||||||
| Address1: | 9714 HEALTHWAY DRIVE | ||||||||
| Address2: | ATLANTIC GENERAL HEALTH SYSTEMS | ||||||||
| City: | BERLIN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218111154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106413340 | ||||||||
| FaxNumber: | 4106413871 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2005 | ||||||||
| LastUpdateDate: | 05/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | H00056241 | MD | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | C20008571 | DE | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | H0056241 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0001053003 | 05 | DE | MEDICAID | 351900700 | 05 | MD | MEDICAID |