Individual
MR. DEEPAK MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
47 CAVALIER BLVD, SUITE 120, FLORENCE, KY 41042-3969
(859) 757-4353
(859) 534-0865
Mailing address
47 CAVALIER BLVD, SUITE 120, FLORENCE, KY 41042-3969
(859) 757-4353
(859) 534-0865
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34456
KY
207RN0300X
Nephrology Physician
Primary
34456
KY
207RN0300X
Nephrology Physician
35.079382
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2275210
—
OH
05
—
64344559
—
KY
Enumeration date
06/20/2006
Last updated
04/25/2013
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