Provider Demographics
NPI:1487831749
Name:DESHMUKH, VRUSHALI (MD)
Entity Type:Individual
Prefix:
First Name:VRUSHALI
Middle Name:
Last Name:DESHMUKH
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-845-8623
Mailing Address - Fax:717-843-6682
Practice Address - Street 1:924B COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3450
Practice Address - Country:US
Practice Address - Phone:717-845-8623
Practice Address - Fax:717-843-6682
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4354222207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP010214OtherGATEWAY-WMG
PA20097164OtherAMERIHEALTH MERCY-WMG
PA288045OtherUNISON-WMG
MD942662OtherCAREFIRST MD BCBS-WMG
PA10239928Medicaid
PA2069535OtherHIGHMARK BLUE SHIELD-WMG
PA133723Medicare PIN
PAP010214OtherGATEWAY-WMG