Healthcare Provider Details

I. General information

NPI: 1275021974
Provider Name (Legal Business Name): DEEPALI DARJI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2018
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

IV. Provider business mailing address

36622 FIVE MILE RD SUITE 101, LIVONIA, MI 48154
LIVONIA MI
48154-3111
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-5662
  • Fax:
Mailing address:
  • Phone: 734-542-0200
  • Fax: 734-542-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number59.000710
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: