Provider Demographics
NPI:1891025722
Name:DESHMUKH, TEJASWINI K (MD)
Entity Type:Individual
Prefix:DR
First Name:TEJASWINI
Middle Name:K
Last Name:DESHMUKH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9000 W WISCONSIN AVE
Mailing Address - Street 2:PEDIATRIC RADIOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4874
Mailing Address - Country:US
Mailing Address - Phone:414-266-1686
Mailing Address - Fax:414-266-1525
Practice Address - Street 1:9000 W WISCONSIN AVE
Practice Address - Street 2:PEDIATRIC RADIOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4874
Practice Address - Country:US
Practice Address - Phone:414-266-1686
Practice Address - Fax:414-266-1525
Is Sole Proprietor?:No
Enumeration Date:2009-12-25
Last Update Date:2024-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2011019862207U00000X, 2085N0700X, 2085P0229X, 2085R0202X
WI573832085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1891025722Medicaid
WI736012476Medicare PIN