Provider Demographics
NPI:1487657896
Name:MCCLAIN, DEBRA R (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:R
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:270 E DAY RD STE 280
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3452
Mailing Address - Country:US
Mailing Address - Phone:574-271-0268
Mailing Address - Fax:574-271-0395
Practice Address - Street 1:270 E DAY RD STE 280
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3452
Practice Address - Country:US
Practice Address - Phone:574-271-0268
Practice Address - Fax:574-271-0395
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01028643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100091000AMedicaid
INEO5311Medicare UPIN
IN100091000AMedicaid