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NPI Code Detail

MEDICARE: DR. DEEPAK SRIVASTAVA M.D.

MEDICARE: DR. DEEPAK SRIVASTAVA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician31258KY
2207LP2900XPain Medicine (Anesthesiology) Physician31258KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00281314OTHERKYRRMCR
261-1427889OTHERKYBLUEGRASS FAMILY HEALTH
350008010OTHERKYPASSPORT HEALTH PLAN
461-1427889OTHERKYCHA
5000000378136OTHERKYANTHEM PROVIDER #
6C20833OTHERKYCUMBERLAND HEALTHCARE INC
7030670000OTHERKYBLACK LUNG
861-1427889OTHERKYTRICARE
961-1427889OTHERKYHUMANA
1061-1427889OTHERKYUHC
11MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346214681
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEEPAK SRIVASTAVA M.D.
Provider Business Mailing Address
First Line : 100 E LIBERTY ST
Second Line : SUITE 800
City : LOUISVILLE
State : KY
Zip : 40202-1434
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1001 SAINT JOSEPH LN
Second Line : ANESTHESIA PROGRAM
City : LONDON
State : KY
Zip : 40741-8345
Country : US
Telephone Number : 606-330-6906
Fax Number : 606-330-6536
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 03/30/2017

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