Provider Demographics
NPI:1780682575
Name:DESHMUKH, KALPANA S (MD)
Entity Type:Individual
Prefix:DR
First Name:KALPANA
Middle Name:S
Last Name:DESHMUKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1710
Mailing Address - Street 2:SOUTH JERSEY RADIOLOGY ASSOCIATES, PA
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7710
Mailing Address - Country:US
Mailing Address - Phone:856-770-0504
Mailing Address - Fax:856-770-0395
Practice Address - Street 1:2776 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5864
Practice Address - Country:US
Practice Address - Phone:239-343-2000
Practice Address - Fax:856-751-0535
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA040361002085R0202X
FLME1257892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101809000Medicaid
10654859OtherCAQH
2100749OtherUNITED HEALTHCARE
300122630OtherRAILROAD MEDICARE
NJ1188704Medicaid
63402OtherPREMIER BLUE
1144632OtherHORIZON NJ HEALTH
2608168OtherAETNA
0057263000OtherAMERIHEALTH HMO
063402OtherAMERIHEALTH PPO
63402OtherHIGHMARK PA BLUE SHIELD
FLMRZ7WOtherBCBS OF FLORIDA
A3738029OtherOXFORD HEALTH
FLKP347OtherMEDICARE