Healthcare Provider Details

I. General information

NPI: 1962432518
Provider Name (Legal Business Name): MICHAEL F DEUCHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7255 OLD OAK BLVD STE C208
CLEVELAND OH
44130-3300
US

IV. Provider business mailing address

7255 OLD OAK BLVD STE C208
CLEVELAND OH
44130-3300
US

V. Phone/Fax

Practice location:
  • Phone: 440-816-2708
  • Fax: 440-243-8480
Mailing address:
  • Phone: 440-816-2708
  • Fax: 440-243-8480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35069143
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: