Provider Demographics
NPI:1154396711
Name:SETH, DEEPAK
Entity type:Individual
Prefix:DR
First Name:DEEPAK
Middle Name:
Last Name:SETH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 WISE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21222-4911
Mailing Address - Country:US
Mailing Address - Phone:410-284-1004
Mailing Address - Fax:410-284-2109
Practice Address - Street 1:207 WISE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-4911
Practice Address - Country:US
Practice Address - Phone:410-284-1004
Practice Address - Fax:410-284-2109
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0033407174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No174400000XOther Service ProvidersSpecialist