Provider Demographics
NPI:1124093307
Name:DESHMUKH, NARAYAN (MD)
Entity type:Individual
Prefix:DR
First Name:NARAYAN
Middle Name:
Last Name:DESHMUKH
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:PO BOX 37086
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3086
Mailing Address - Country:US
Mailing Address - Phone:240-439-8733
Mailing Address - Fax:240-439-8910
Practice Address - Street 1:400 W 7TH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701
Practice Address - Country:US
Practice Address - Phone:240-566-3840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249486208600000X
IL0361350712083P0011X
IL036135072208600000X
MDD78323208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA770002509OtherRR MEDICARE PIN
PA0006851630001Medicaid
NY00365191Medicaid
PACC9269OtherRR MEDICARE GROUP
PAGU039818OtherMEDICARE GROUP
PACC9269OtherRR MEDICARE GROUP
PA770002509OtherRR MEDICARE PIN
PA124587N8SMedicare ID - Type Unspecified
IL214881Medicare Oscar/Certification