Provider Demographics
NPI:1497014187
Name:MUGHAL, DEEPTI KAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPTI KAUL
Middle Name:
Last Name:MUGHAL
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 1:6011 SHADEHILL RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5195
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:965 FEE ROAD, ROOM A233
Practice Address - Street 2:MSU & AFFILIATED HOSPITALS PSYCHIATRY RESIDENCY PROGRAM
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-1316
Practice Address - Country:US
Practice Address - Phone:517-432-2993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43011005032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry