Healthcare Provider Details

I. General information

NPI: 1306158779
Provider Name (Legal Business Name): DEXTER AUGUSTINE PREUGSCHAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE
SPOKANE WA
99204-2307
US

IV. Provider business mailing address

101 W 8TH AVE
SPOKANE WA
99204-2307
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-6841
  • Fax:
Mailing address:
  • Phone: 509-474-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD60294402
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD60294402
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: