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Individual

DR. STEVEN DOUGLAS DEITCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
617 23RD ST, ASHLAND, KY 41101-2880
(606) 326-0300
(606) 326-0235
Mailing address
PO BOX 2379, ASHLAND, KY 41105-2379
(606) 408-4000

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
26535
KY
2084N0400X
Neurology Physician
Primary
26535
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000049311
BLUE CROSS
KY
01
000000733227
BCBS
KY
05
0042484000
WV
05
0742594
OH
01
1030745
WEST VIRGINIA WORKERS COM
WV
01
26-4183569
AETNA
KY
01
4347345
AETNA
KY
05
64265358
KY
Enumeration date
09/16/2006
Last updated
06/28/2017
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