Provider Demographics
NPI:1053390542
Name:VERMETTE, DEBRA (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:
Last Name:VERMETTE
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 1:1787 SENTRY PKWY W BLDG 16
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2239
Mailing Address - Country:US
Mailing Address - Phone:215-542-3000
Mailing Address - Fax:215-542-3070
Practice Address - Street 1:1787 SENTRY PKWY W BLDG 16
Practice Address - Street 2:SUITE 400
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2239
Practice Address - Country:US
Practice Address - Phone:215-542-3000
Practice Address - Fax:215-542-3070
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2874207Q00000X
DEC1-0009780207Q00000X
PAMD455783207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F40578Medicare UPIN