Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 24749 | NE |
N | 111NI0900X | Internist | 24749 | NE |
N | 207RC0000X | Internist - Cardiovascular Disease | 24749 | NE |
Y | 207RC0000X | Internist - Cardiovascular Disease | 38455 | IA |
N | 207RI0011X | Interventional Cardiology | 24749 | NE |
N | 207RI0011X | Interventional Cardiology | 38455 | IA |
NPI | 1003022708 |
---|---|
Provider Name | Anand Deshmukh |
First Address | Omaha, NE 68103-0755 |
Second Address | Council Bluffs, IA 51503-4658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 21/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
075120016 | (02) | IA |
10026209700 | (05) | NE |
1003022708 | (05) | IA |