Provider Demographics
NPI:1922446962
Name:SEKARAN, DEEPAK UDUPA (MD)
Entity Type:Individual
Prefix:
First Name:DEEPAK
Middle Name:UDUPA
Last Name:SEKARAN
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 1:313 ROLLINGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-3250
Mailing Address - Country:US
Mailing Address - Phone:252-744-5069
Mailing Address - Fax:252-744-3156
Practice Address - Street 1:250 SMITH CHURCH RD
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4914
Practice Address - Country:US
Practice Address - Phone:252-537-8715
Practice Address - Fax:252-535-8589
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
NC2021-02111207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No282N00000XHospitalsGeneral Acute Care Hospital