Provider Demographics
NPI:1942224522
Name:DESHMUKH, DEEPAK (DO)
Entity Type:Individual
Prefix:
First Name:DEEPAK
Middle Name:
Last Name:DESHMUKH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:600 GRESHAM DR
Mailing Address - Street 2:STE 8620
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1904
Mailing Address - Country:US
Mailing Address - Phone:757-622-2649
Mailing Address - Fax:757-625-0433
Practice Address - Street 1:600 GRESHAM DR
Practice Address - Street 2:STE 8620
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-622-2649
Practice Address - Fax:757-625-0433
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01022022832086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMC10620Medicare PIN