Provider Demographics
NPI:1457329138
Name:PITSCHKA, STEVEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:PITSCHKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 10TH AVE NE
Mailing Address - Street 2:ESSENTIA HEALTH DEER RIVER
Mailing Address - City:DEER RIVER
Mailing Address - State:MN
Mailing Address - Zip Code:56636-8795
Mailing Address - Country:US
Mailing Address - Phone:218-246-2900
Mailing Address - Fax:
Practice Address - Street 1:115 10TH AVE NE
Practice Address - Street 2:ESSENTIA HEALTH DEER RIVER
Practice Address - City:DEER RIVER
Practice Address - State:MN
Practice Address - Zip Code:56636-8795
Practice Address - Country:US
Practice Address - Phone:218-246-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39852207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080013301OtherMEDICARE WPS - HOSPITAL
MN677957300Medicaid
MN080015007OtherMEDICARE WPS - MCGREGOR C
MN080015008OtherMEDICARE WPS - AITKIN CLI
G53229Medicare UPIN