Provider Demographics
NPI:1154685592
Name:AMBERKER, DEEPA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPA
Middle Name:
Last Name:AMBERKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 OLD YORK RD
Mailing Address - Street 2:SUITE 2B, ELKINS BUILDING
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3720
Mailing Address - Country:US
Mailing Address - Phone:215-481-2000
Mailing Address - Fax:
Practice Address - Street 1:3571 W WHEATLAND RD STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3461
Practice Address - Country:US
Practice Address - Phone:972-274-5555
Practice Address - Fax:972-274-5663
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5690207RN0300X
PAMD455074207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX634169YT1POtherMEDICARE