Provider Demographics
NPI:1730135278
Name:BASKARAN, DEEPAK (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPAK
Middle Name:
Last Name:BASKARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HARBORVIEW DR
Mailing Address - Street 2:#908
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5415
Mailing Address - Country:US
Mailing Address - Phone:443-838-5867
Mailing Address - Fax:
Practice Address - Street 1:3455 WILKENS AVE
Practice Address - Street 2:LL10
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5213
Practice Address - Country:US
Practice Address - Phone:410-644-4444
Practice Address - Fax:410-644-4484
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062757207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine