Provider Demographics
NPI:1013142827
Name:KAMAT, DEEPTI VIDHYESH (MD)
Entity Type:Individual
Prefix:
First Name:DEEPTI
Middle Name:VIDHYESH
Last Name:KAMAT
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4967 CROOKS RD
Mailing Address - Street 2:STE 130
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-5801
Mailing Address - Country:US
Mailing Address - Phone:248-952-1601
Mailing Address - Fax:248-952-1614
Practice Address - Street 1:4201 ST ANTIONE
Practice Address - Street 2:DETROIT MEDICAL CENTER
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-6507
Practice Address - Country:US
Practice Address - Phone:734-464-0887
Practice Address - Fax:734-402-0254
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-22
Last Update Date:2015-08-26
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Provider Licenses
StateLicense IDTaxonomies
MI4301092556207R00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery