Provider Demographics
NPI:1841253127
Name:DEONARINE, MAHINDRANAUTH (MD)
Entity type:Individual
Prefix:
First Name:MAHINDRANAUTH
Middle Name:
Last Name:DEONARINE
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 1:3 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-3408
Mailing Address - Country:US
Mailing Address - Phone:301-625-2801
Mailing Address - Fax:301-625-1627
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:SUITE 308
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:301-459-6655
Practice Address - Fax:301-459-6695
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-08
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00549262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD079400700Medicaid
DC00B089M25Medicare PIN
MDH33110Medicare UPIN
DC009896A75Medicare PIN