MEDICARE: DR. STEVEN DELASHMUTT M.D.

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
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	MD12442	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821030552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN DELASHMUTT M.D.

Provider Business Mailing Address
First Line	:	3640 H ST
Second Line	:
City	:	BAKER CITY
State	:	OR
Zip	:	97814-1278
Country	:	US
Telephone Number	:	541-523-6125
Fax Number	:

Provider Business Practice Location Address
First Line	:	3640 H ST
Second Line	:
City	:	BAKER CITY
State	:	OR
Zip	:	97814-1278
Country	:	US
Telephone Number	:	541-523-6125
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	07/13/2007

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