Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 044444 | GA |
Y | 208600000X | Surgeon | 044444 | GA |
NPI | 1013991371 |
---|---|
Provider Name | Mark F Deutsch |
First Address | Atlanta, GA 30342-1626 |
Second Address | Atlanta, GA 30342-1626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 16/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000768611F | (05) | GA |
E73219 | (02) | GA |