Provider Demographics
NPI:1063488187
Name:DESHMUKH, SATYAJIT HANUMANT (MD)
Entity Type:Individual
Prefix:DR
First Name:SATYAJIT
Middle Name:HANUMANT
Last Name:DESHMUKH
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 1:512 HWY 71
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:TX
Mailing Address - Zip Code:78602
Mailing Address - Country:US
Mailing Address - Phone:512-321-0911
Mailing Address - Fax:512-321-0917
Practice Address - Street 1:512 HWY 71
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602
Practice Address - Country:US
Practice Address - Phone:512-321-0911
Practice Address - Fax:512-321-0917
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5151207P00000X
IL036.118292207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02699618Medicaid
NY02699618Medicaid