Provider Demographics
NPI:1891927455
Name:DESHPANDE, SHRIKANT R (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SHRIKANT
Middle Name:R
Last Name:DESHPANDE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:52 HAZELNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-3268
Mailing Address - Country:US
Mailing Address - Phone:860-446-8265
Mailing Address - Fax:860-448-6961
Practice Address - Street 1:52 HAZELNUT HILL RD
Practice Address - Street 2:52 HAZELNUT HILL ROAD
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3268
Practice Address - Country:US
Practice Address - Phone:860-446-8265
Practice Address - Fax:860-448-6961
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0197522083X0100X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine