Provider Demographics
NPI:1932259165
Name:DEUTSCH, FREDERICK E (DC)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:E
Last Name:DEUTSCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 10TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-4110
Mailing Address - Country:US
Mailing Address - Phone:605-886-8650
Mailing Address - Fax:605-886-8663
Practice Address - Street 1:810 10TH ST SW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-4110
Practice Address - Country:US
Practice Address - Phone:605-886-8650
Practice Address - Fax:605-886-8663
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD634111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7602120Medicaid
T66548Medicare UPIN
SD86507Medicare ID - Type Unspecified