Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301092556 | MI |
Y | 111NI0900X | Internist | 4301092556 | MI |
N | 208200000X | Surgeon | 4301092556 | MI |
N | 208600000X | Surgeon | 4301092556 | MI |
NPI | 1013142827 |
---|---|
Provider Name | Deepti Vidhyesh Kamat |
First Address | Troy, MI 48098-5801 |
Second Address | Detroit, MI 48201-6507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2009 |
Last Update Date | 26/08/2015 |