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NPI Code Detail

MEDICARE: NINA DEEP M.D.

MEDICARE:   NINA  DEEP  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35-06-9940OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154308369
Entity Type Code : Individual
Provider Name (Legal Business Name) : NINA DEEP M.D.
Provider Business Mailing Address
First Line : 5150 E DUBLIN GRANVILLE RD
Second Line : SUITE 100
City : WESTERVILLE
State : OH
Zip : 43081-8701
Country : US
Telephone Number : 614-855-5555
Fax Number :
Provider Business Practice Location Address
First Line : 5150 E DUBLIN GRANVILLE RD
Second Line : SUITE 100
City : WESTERVILLE
State : OH
Zip : 43081-8701
Country : US
Telephone Number : 614-855-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 05/22/2012

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