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NPI Code Detail

MEDICARE: MICHAEL JOHN DEUTSCHMAN LPN

MEDICARE: MICHAEL JOHN DEUTSCHMAN LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLPN.135470.M-IVOH

General Provider Information

NPI Number : 1528517380
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JOHN DEUTSCHMAN LPN
Provider Business Mailing Address
First Line : 3203 CLEVELAND AVE S
Second Line :
City : CANTON
State : OH
Zip : 44707-1439
Country : US
Telephone Number : 330-388-0732
Fax Number :
Provider Business Practice Location Address
First Line : 15 FREDERICK AVE
Second Line :
City : AKRON
State : OH
Zip : 44310-2904
Country : US
Telephone Number : 330-996-7730
Fax Number : 330-996-7742
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2016
Last Update Date : 09/22/2016

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