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NPI Code Detail

MEDICARE: DEEPAK BHAMIDIPATI

MEDICARE: DEEPAK BHAMIDIPATI
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207RH0003XHematology & Oncology Physician72503TN

General Provider Information

NPI Number : 1912402413
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEEPAK BHAMIDIPATI
Provider Business Mailing Address
First Line : 2 MESA LN
Second Line :
City : MALVERN
State : PA
Zip : 19355-2922
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 335 24TH AVE N STE 200
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-1516
Country : US
Telephone Number : 615-329-7640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2018
Last Update Date : 10/18/2024

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Directions to “ DEEPAK BHAMIDIPATI ” Practice Location

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