Healthcare Provider Details

I. General information

NPI: 1992540678
Provider Name (Legal Business Name): RAMAN DEEP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date: 03/21/2025
Reactivation Date: 08/11/2025

III. Provider practice location address

625 19TH STREET SOUTH
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-996-5933
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberL.6680
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: