Provider Demographics
NPI:1568621696
Name:ZUTSHI, DEEPTI (MD)
Entity Type:Individual
Prefix:
First Name:DEEPTI
Middle Name:
Last Name:ZUTSHI
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 1:1560 E MAPLE RD
Mailing Address - Street 2:SUITE 400-CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1138
Mailing Address - Country:US
Mailing Address - Phone:313-745-4275
Mailing Address - Fax:313-745-4468
Practice Address - Street 1:4201 ST ANTOINE
Practice Address - Street 2:STE 8A & 8B
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-4275
Practice Address - Fax:313-745-4468
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA661142084N0400X
MI43011026912084N0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P30630864Medicare PIN