Provider Demographics
NPI:1013991371
Name:DEUTSCH, MARK F (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:F
Last Name:DEUTSCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:980 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 760
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1626
Mailing Address - Country:US
Mailing Address - Phone:770-461-4824
Mailing Address - Fax:770-461-2601
Practice Address - Street 1:980 JOHNSON FERRY RD NE
Practice Address - Street 2:SUITE 760
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1626
Practice Address - Country:US
Practice Address - Phone:770-461-4824
Practice Address - Fax:770-461-2601
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2008-06-16
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Provider Licenses
StateLicense IDTaxonomies
GA044444208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000768611FMedicaid
GA000768611FMedicaid
GA24BCBWZMedicare PIN