Healthcare Provider Details

I. General information

NPI: 1154396711
Provider Name (Legal Business Name): DR. DEEPAK SETH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 WISE AVE
BALTIMORE MD
21222-4911
US

IV. Provider business mailing address

207 WISE AVE
BALTIMORE MD
21222-4911
US

V. Phone/Fax

Practice location:
  • Phone: 410-284-1004
  • Fax: 410-284-2109
Mailing address:
  • Phone: 410-284-1004
  • Fax: 410-284-2109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberD0033407
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0033407
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: