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Individual

ANDREW R. DEITSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1485 CHESTER BLVD., RICHMOND, IN 47374-1919
(765) 966-5527
(765) 966-5528
Mailing address
1100 REID PARKWAY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 966-5527
(765) 966-5528

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01050945A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100256540A
IN
Enumeration date
08/02/2005
Last updated
05/13/2021
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