# DEEP KUKRETI AND ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457674327
- **Authorized official:** MR. DEEP KUKRETI M.D (MEDICAL DOCTOR)
- **Authorized official phone:** (301) 776-4996

## Contact information

- **Practice address:** 9900 WASHINGTON BLVD N, SUITE L, LAUREL, MD 20723-1971
- **Practice address phone:** (301) 776-4996
- **Practice address fax:** (301) 483-8810
- **Mailing address:** 9900 WASHINGTON BLVD N, SUITE L, LAUREL, MD 20723-1971
- **Mailing address phone:** (301) 776-4996
- **Mailing address fax:** (301) 483-8810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | D0052075 | MD | Yes |

## Other

- **Enumeration date:** 03/08/2010
- **Last updated:** 03/08/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1275507550 | — | MD |