Healthcare Provider Details

I. General information

NPI: 1881695252
Provider Name (Legal Business Name): BRIAN DEUTSCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 KEMPSVILLE RD STE 221
NORFOLK VA
23502-3800
US

IV. Provider business mailing address

885 KEMPSVILLE RD STE 221
NORFOLK VA
23502-3800
US

V. Phone/Fax

Practice location:
  • Phone: 757-623-0526
  • Fax: 757-623-0609
Mailing address:
  • Phone: 757-623-0526
  • Fax: 757-623-0609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number0101045219
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: