MEDICARE: DEEPTI ADHIKARI GURAGAIN MD

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
1	390200000X	Student in an Organized Health Care Education/Training Program	MT198556	PA
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	MD453578	PA

General Provider Information

NPI Number	:	1972898740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEEPTI ADHIKARI GURAGAIN MD

Provider Business Mailing Address
First Line	:	100 S 2ND STREET
Second Line	:	#301
City	:	HARRISBURG
State	:	PA
Zip	:	17101
Country	:	US
Telephone Number	:	717-782-3340
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S 2ND ST STE 301
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17101-2545
Country	:	US
Telephone Number	:	717-782-3340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	07/21/2022

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