Provider Demographics
NPI:1053475707
Name:BUCKLAND-COFFEY, DEBRA DEANNE (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:DEANNE
Last Name:BUCKLAND-COFFEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBRA
Other - Middle Name:DEANNE
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:WALTER REED NATIONAL MILITARY MEDICAL CENTER
Mailing Address - Street 2:8901 ROCKVILLE PIKE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-5000
Mailing Address - Country:US
Mailing Address - Phone:301-295-0568
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED NATIONAL MILITARY MEDICAL CENTER
Practice Address - Street 2:8901 ROCKVILLE PIKE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5000
Practice Address - Country:US
Practice Address - Phone:301-295-0568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE24318207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD0000Medicare UPIN