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General NPI Number Information
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NPI Number | 1750331757
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Entity Type | Individual
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Provider Name | ADAM DEUTCHMAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 805 MAIN ST
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City | SALMON
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State | ID
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Zip | 83467-0000
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Country | US
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Telephone | 208-756-6212
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Fax | 208-756-6336
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Provider Business Mailing Address
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Address Line | 203 S DAISY ST
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City | SALMON
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State | ID
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Zip | 83467-0000
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Country | US
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Telephone | 208-756-5600
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Fax | 208-756-4169
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0424797
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | DR-33966
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 119790
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | M-9041
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 11652
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License Number State | MT
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