MEDICARE: DR. DEEPAK SARWAL 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
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	35-07-71-66S	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1235159559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEPAK SARWAL M.D.

Provider Business Mailing Address
First Line	:	4331 NAPA VALLEY DR
Second Line	:
City	:	BELLBROOK
State	:	OH
Zip	:	45305-1567
Country	:	US
Telephone Number	:	937-848-7764
Fax Number	:

Provider Business Practice Location Address
First Line	:	5563 FAR HILLS AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-2225
Country	:	US
Telephone Number	:	937-291-0839
Fax Number	:	937-291-0854

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	11/30/2007

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