Provider Demographics
NPI:1750470811
Name:DUTER, DAVID ALAN (CEHT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ALAN
Last Name:DUTER
Suffix:
Gender:M
Credentials:CEHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:OOSTBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53070-1132
Mailing Address - Country:US
Mailing Address - Phone:414-747-7111
Mailing Address - Fax:414-747-7891
Practice Address - Street 1:USCG SECTOR LAKE MICHIGAN/HS DIV
Practice Address - Street 2:2420 S. LINCOLN MEMORIAL DR.
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207
Practice Address - Country:US
Practice Address - Phone:414-747-7111
Practice Address - Fax:414-747-7891
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other