Individual
NINA DEEP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5150 E DUBLIN GRANVILLE RD, SUITE 100, WESTERVILLE, OH 43081-8701
(614) 855-5555
Mailing address
5150 E DUBLIN GRANVILLE RD, SUITE 100, WESTERVILLE, OH 43081-8701
(614) 855-5555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-06-9940
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2045209
—
OH
Enumeration date
12/29/2005
Last updated
05/22/2012
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