Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | $$$$$$$$$ | FL |
Y | 222Z00000X | Podiatrist | $$$$$$$$$ | FL |
NPI | 1003173931 |
---|---|
Provider Name | Mr. Deepak Kumar |
First Address | Lake Worth, FL 33460-1958 |
Second Address | Detroit, MI 48226-4324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2012 |
Last Update Date | 17/04/2012 |