Individual
LAKSHMI DEEP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
W10618 CLINIC ST, ELCHO, WI 54428-9619
(715) 275-4011
Mailing address
3000 WESTHILL DR, SUITE 303, WAUSAU, WI 54401-3795
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43194
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34080500
—
WI
Enumeration date
07/10/2006
Last updated
07/08/2007
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