Provider Demographics
NPI:1851556849
Name:DEUTSCH, STEPHAN D (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:D
Last Name:DEUTSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 WAYLAND AVE UNIT 316N
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4565
Mailing Address - Country:US
Mailing Address - Phone:401-751-2855
Mailing Address - Fax:401-751-2288
Practice Address - Street 1:1 WAYLAND AVE UNIT 316N
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4565
Practice Address - Country:US
Practice Address - Phone:401-751-2855
Practice Address - Fax:401-751-2288
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-19
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD04988207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery