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General NPI Number Information
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NPI Number | 1497014187
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Entity Type | Individual
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Provider Name | DEEPTI KAUL MUGHAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 965 FEE ROAD, ROOM A233 MSU & AFFILIATED HOSPITALS PSYCHIATRY RESIDENCY PROGRAM
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City | EAST LANSING
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State | MI
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Zip | 48824-1316
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Country | US
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Telephone | 517-432-2993
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Fax |
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Provider Business Mailing Address
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Address Line | 6011 SHADEHILL RD
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5195
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301100503
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License Number State | MI
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