Provider Demographics
NPI:1275021974
Name:DARJI, DEEPALI
Entity Type:Individual
Prefix:
First Name:DEEPALI
Middle Name:
Last Name:DARJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36622 FIVE MILE RD SUITE 101, LIVONIA, MI 48154
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3111
Mailing Address - Country:US
Mailing Address - Phone:734-542-0200
Mailing Address - Fax:734-542-0220
Practice Address - Street 1:36622 FIVE MILE RD STE 101
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1900
Practice Address - Country:US
Practice Address - Phone:734-542-0200
Practice Address - Fax:734-542-0220
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH59.000710213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty