Provider Demographics
NPI:1902035918
Name:KAUSHAL, MANU DEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:MANU
Middle Name:DEEP
Last Name:KAUSHAL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:18109 PRINCE PHILIP DR
Mailing Address - Street 2:SUITE B-100
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1519
Mailing Address - Country:US
Mailing Address - Phone:301-774-8962
Mailing Address - Fax:301-774-8963
Practice Address - Street 1:18109 PRINCE PHILIP DR
Practice Address - Street 2:SUITE B-100
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1519
Practice Address - Country:US
Practice Address - Phone:301-774-8962
Practice Address - Fax:301-774-8963
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-11
Last Update Date:2019-04-15
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Provider Licenses
StateLicense IDTaxonomies
MDD81574207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine