Basic Information
| Provider Information | |||||||||
| NPI: | 1649483272 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POWELL | ||||||||
| FirstName: | DEBRA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 S 7TH AVE | ||||||||
| Address2: | |||||||||
| City: | WEST READING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196111410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4846284630 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 301 S 7TH AVE | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | WEST READING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196111410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4846284630 | ||||||||
| FaxNumber: | 6103748324 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 07/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | MD433966 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 126412 | 01 | PA | MEDICARE ID | OTHER | 102165835 | 05 | PA | MEDICAID |