Provider Demographics
NPI:1780278366
Name:DHARAMRUP, DEEPA
Entity type:Individual
Prefix:
First Name:DEEPA
Middle Name:
Last Name:DHARAMRUP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4566 BOGIE RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4404
Mailing Address - Country:US
Mailing Address - Phone:404-729-1397
Mailing Address - Fax:
Practice Address - Street 1:4566 BOGIE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4404
Practice Address - Country:US
Practice Address - Phone:404-729-1397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist