Provider Demographics
NPI:1134434988
Name:DE SCHUTTER, ALBAN (MD)
Entity type:Individual
Prefix:
First Name:ALBAN
Middle Name:
Last Name:DE SCHUTTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E HASKELL ST
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-3247
Mailing Address - Country:US
Mailing Address - Phone:775-375-1280
Mailing Address - Fax:775-375-0496
Practice Address - Street 1:118 E HASKELL ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3247
Practice Address - Country:US
Practice Address - Phone:775-375-1280
Practice Address - Fax:775-375-0496
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17522207RC0000X
LAMD.206862390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease