Individual
DEEPAK DAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
78 NORTH CHURCH STREET, HAZLETON, PA 18201-5802
(570) 459-6666
(570) 459-5386
Mailing address
78 NORTH CHURCH STREET, HAZLETON, PA 18201-5802
(570) 459-6666
(570) 459-5386
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD040293L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011614630003
—
PA
01
—
073625
FIRST PRIORITY HEALTH
—
01
—
111134
BLACK LUNG
—
01
—
180039776
RAILROAD MEDICARE
—
01
—
202616
EEOICP
—
01
—
34225
GEISINGER HEALTH PLAN
—
01
—
510552
BLUE CROSS / BLUE SHIELD
—
Enumeration date
08/09/2005
Last updated
11/22/2011
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