Individual
DR. MICHAEL E DEITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
475 BRADLEY BLVD, RICHLAND, WA 99352-4419
(509) 943-2240
(509) 943-1575
Mailing address
475 BRADLEY BLVD, RICHLAND, WA 99352-4419
(509) 943-2240
(509) 943-1575
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD21436
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1004901
COMMUNITY HEALTH PLAN
WA
05
—
1011998
—
WA
05
—
152595
—
OR
01
—
26051
LABOR & INDUSTRIES
WA
01
—
314
GROUP HEALTH
WA
01
—
350230
UNITED HEALTHCARE
—
01
—
5438375
AETNA
—
Enumeration date
12/20/2005
Last updated
02/15/2008
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