Healthcare Provider Details

I. General information

NPI: 1972598464
Provider Name (Legal Business Name): STEVEN A DUTCHER DO PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4560 LANTANA RD STE 120
LAKE WORTH FL
33463-6998
US

IV. Provider business mailing address

4560 LANTANA RD STE 120
LAKE WORTH FL
33463-6998
US

V. Phone/Fax

Practice location:
  • Phone: 561-433-4444
  • Fax: 561-433-8877
Mailing address:
  • Phone: 561-433-4444
  • Fax: 561-433-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberOS 8151
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: