MEDICARE: MR. DEEPAK CUDDAPAH MD

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	207R00000X	Internal Medicine Physician	01349	NC

General Provider Information

NPI Number	:	1801994819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DEEPAK CUDDAPAH MD

Provider Business Mailing Address
First Line	:	2000 PERIMETER PARK DR STE 200
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	208 COX BLVD STE 102
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-9414
Country	:	US
Telephone Number	:	919-731-6018
Fax Number	:	919-580-7010

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	05/06/2021

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