Individual
DR. JOHN R DEITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 MONUMENT RD, SUITE 290, YORK, PA 17403-5060
(717) 812-4090
(717) 812-4092
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 812-4090
(717) 812-4092
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD421588
PA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD421588
PA
207XX0801X
Orthopaedic Trauma Physician
MD421588
PA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
MD421588
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001947744
—
PA
01
—
1469568
HIGHMARK BLUE SHIELD
PA
01
—
1533804
GATEWAY-WMG
PA
01
—
20091796
AMERIHEALTH MERCY-WMG
PA
01
—
273200
UNISON-WMG
PA
01
—
955041
CAREFIRST MD BCBS-WMG
MD
Enumeration date
04/13/2006
Last updated
06/30/2016
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