Provider Demographics
NPI:1972713709
Name:DESHMUKH, MRUNALINI (MD)
Entity Type:Individual
Prefix:DR
First Name:MRUNALINI
Middle Name:
Last Name:DESHMUKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 CORPORATE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-8230
Mailing Address - Country:US
Mailing Address - Phone:484-526-7300
Mailing Address - Fax:610-791-3107
Practice Address - Street 1:3701 CORPORATE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-8230
Practice Address - Country:US
Practice Address - Phone:484-526-7300
Practice Address - Fax:610-791-3107
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437291207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102386451Medicaid
PA102386451Medicaid