Basic Information
| Provider Information | |||||||||
| NPI: | 1982832473 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DESHMANE | ||||||||
| FirstName: | PRASHANT | ||||||||
| MiddleName: | PRAKASH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 MEDICAL PARK DR | ||||||||
| Address2: | |||||||||
| City: | HARTSVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295504765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433833742 | ||||||||
| FaxNumber: | 8433833745 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 MEDICAL PARK DR | ||||||||
| Address2: | |||||||||
| City: | HARTSVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295504765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433833742 | ||||||||
| FaxNumber: | 8433833745 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2009 | ||||||||
| LastUpdateDate: | 05/31/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0114X | 34496 | SC | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery | 207XX0005X | 34496 | SC | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 207X00000X | 34496 | SC | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.