Provider Demographics
NPI:1942220090
Name:DESHPANDE, ANIL S (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:S
Last Name:DESHPANDE
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 1:796 NEWTOWN YARDLEY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1748
Mailing Address - Country:US
Mailing Address - Phone:609-537-5600
Mailing Address - Fax:609-537-7394
Practice Address - Street 1:796 NEWTOWN YARDLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1748
Practice Address - Country:US
Practice Address - Phone:609-537-5600
Practice Address - Fax:609-537-7394
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023016E208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010260930002Medicaid
PA0010260930007Medicaid
PA4084554OtherAETNA
PA413525OtherHIGHMARK BLUE SHIELD
PA622997400OtherDEPARTMENT OF LABOR
PA622997400OtherDEPARTMENT OF LABOR
PA4084554OtherAETNA
PA0010260930007Medicaid
PAB41398Medicare UPIN