Individual
DEEPAK MAVAHALLI SAMPATHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 1 SILVERSTEIN, PHILADELPHIA, PA 19104
(215) 662-3000
Mailing address
3400 SPRUCE ST, 1 SILVERSTEIN, PHILADELPHIA, PA 19104
(215) 662-3000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
MD447827
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD447827
PA
Other
Enumeration date
07/06/2007
Last updated
08/12/2015
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