Provider Demographics
NPI:1710966239
Name:BALDEMOR, DEBORAH L (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:BALDEMOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9458 E IRONWOOD SQUARE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4571
Mailing Address - Country:US
Mailing Address - Phone:480-767-7699
Mailing Address - Fax:
Practice Address - Street 1:9458 E IRONWOOD SQUARE DR STE 102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4571
Practice Address - Country:US
Practice Address - Phone:480-767-7699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26429207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZG69627Medicare UPIN
AZ437378Medicare ID - Type Unspecified
AZ23986Medicare ID - Type Unspecified