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General NPI Number Information
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NPI Number | 1487881215
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Entity Type | Individual
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Provider Name | SAMEER M DESHMUKH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 8008 WESTPARK DR
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City | TYSONS
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State | VA
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Zip | 22102-3109
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Country | US
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Telephone | 703-287-4585
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31309
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City | LOS ANGELES
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State | CA
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Zip | 90031-0309
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Country | US
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Telephone | 323-865-3700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 246245
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A134566
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License Number State | CA
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