Provider Demographics
NPI:1003261959
Name:DEEPAK SETH, MD INTERNAL MEDICINE AND FAMILY PRACTICE
Entity Type:Organization
Organization Name:DEEPAK SETH, MD INTERNAL MEDICINE AND FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-284-1004
Mailing Address - Street 1:207 WISE AVE
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222-4911
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 WISE AVE
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-4911
Practice Address - Country:US
Practice Address - Phone:410-284-1004
Practice Address - Fax:410-284-2109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005040261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center