Active NPI
Philip A Dauterman, MD
- Anatomic Pathology & Clinical Pathology Physician
- Saipan, MP
National Provider Identifier
1225094055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- M-1177
- Practice address
- 1 Lower Navy Hill Road
Saipan, MP 96950 - Phone
- (670) 234-8950
- Fax
- (670) 236-8612
- NPI assigned
- Apr 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | M-1177 | GU | Primary |
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | M-1177 | GU |
Addresses
Primary practice location
1 Lower Navy Hill Road
Saipan, MP 96950
Mailing address
1 Lower Navy Hill Road
Saipan, MP 96950
Phone (670) 234-8950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-1177 | GU | MD | Clinical Pathology/Laboratory Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473206400000",
"number": "1225094055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LOWER NAVY HILL ROAD",
"city": "SAIPAN",
"state": "MP",
"postal_code": "96950",
"telephone_number": "670-234-8950",
"fax_number": "670-236-8612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LOWER NAVY HILL ROAD",
"city": "SAIPAN",
"state": "MP",
"postal_code": "96950",
"telephone_number": "670-234-8950",
"fax_number": "670-236-8612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUTERMAN",
"first_name": "PHILIP",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2016-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "GU",
"license": "M-1177",
"primary": true
},
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "GU",
"license": "M-1177",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saipan, MP
- CWM Trust, LLC. (Eucon Medical Health Services)
- D.M. Sablan Holdings Co., LLC
- Carl Daigle, M.D.
- Jordan Despabiladeras Danao, R.N.
- Hormazdiar Dara Dastoor, M.D.
- Gabriel Banu De Guzman, M.D.
- Steven Michael Debulgado, DDS
- Christian Kyle Gerardo Decampong, PT, DPT
- Dental Care, Inc.
- Diamond Care, L.L.C (Diamond Home Health Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.