MEDICARE: BRIAN DEUTSCH 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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	0101045219	VA

General Provider Information

NPI Number	:	1881695252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN DEUTSCH M.D.

Provider Business Mailing Address
First Line	:	885 KEMPSVILLE RD STE 221
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-3800
Country	:	US
Telephone Number	:	757-623-0526
Fax Number	:	757-623-0609

Provider Business Practice Location Address
First Line	:	885 KEMPSVILLE RD STE 221
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-3800
Country	:	US
Telephone Number	:	757-623-0526
Fax Number	:	757-623-0609

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	05/20/2021

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