Provider Demographics
NPI:1740273960
Name:DESHMUKH, AVINASH S (MD)
Entity type:Individual
Prefix:DR
First Name:AVINASH
Middle Name:S
Last Name:DESHMUKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2108 RIVER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1097
Mailing Address - Country:US
Mailing Address - Phone:828-299-4418
Mailing Address - Fax:828-299-4418
Practice Address - Street 1:5705 MONCLOVA RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1875
Practice Address - Country:US
Practice Address - Phone:419-893-0902
Practice Address - Fax:419-891-0152
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35035526208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0302096Medicaid
OH340004874OtherRAIL ROAD MEDICARE PIN
OH0302096Medicaid
OHA75532Medicare UPIN