Provider Demographics
NPI:1972598464
Name:DUTCHER, STEVEN A (DO PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:DUTCHER
Suffix:
Gender:M
Credentials:DO PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3319 STATE ROAD 7
Mailing Address - Street 2:SUITE 313
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8093
Mailing Address - Country:US
Mailing Address - Phone:561-433-4444
Mailing Address - Fax:561-433-8877
Practice Address - Street 1:3319 STATE ROAD 7
Practice Address - Street 2:SUITE 313
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8093
Practice Address - Country:US
Practice Address - Phone:561-433-4444
Practice Address - Fax:561-433-8877
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2015-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 8151207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012024200Medicaid
FL012024200Medicaid
FL58675XMedicare PIN