Healthcare Provider Details

I. General information

NPI: 1528018249
Provider Name (Legal Business Name): DEEPAK GOVIND BHOJRAJ M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3586 N HOBART RD SUITE C
HOBART IN
46342-1442
US

IV. Provider business mailing address

3586 N HOBART RD SUITE C
HOBART IN
46342-1442
US

V. Phone/Fax

Practice location:
  • Phone: 219-962-6500
  • Fax: 219-965-3853
Mailing address:
  • Phone: 219-962-6500
  • Fax: 219-965-3853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01029381A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: