Provider Demographics
NPI:1316190101
Name:DEUTSCHMANN, SELAM BELAY (DC)
Entity type:Individual
Prefix:DR
First Name:SELAM
Middle Name:BELAY
Last Name:DEUTSCHMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5219 DELMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1027
Mailing Address - Country:US
Mailing Address - Phone:314-454-1437
Mailing Address - Fax:314-361-9355
Practice Address - Street 1:5219 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1027
Practice Address - Country:US
Practice Address - Phone:314-454-1437
Practice Address - Fax:314-361-9355
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000151987111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician