Basic Information
| Provider Information | |||||||||
| NPI: | 1003261959 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DEEPAK SETH, MD INTERNAL MEDICINE AND FAMILY PRACTICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 207 WISE AVE | ||||||||
| Address2: | |||||||||
| City: | DUNDALK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212224911 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 207 WISE AVE | ||||||||
| Address2: | |||||||||
| City: | DUNDALK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212224911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102841004 | ||||||||
| FaxNumber: | 4102842109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2016 | ||||||||
| LastUpdateDate: | 04/28/2016 | ||||||||
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| AuthorizedOfficialLastName: | SETH | ||||||||
| AuthorizedOfficialFirstName: | DEEPAK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | M.D. | ||||||||
| AuthorizedOfficialTelephone: | 4102841004 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | C0005040 | MD | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.