Individual
DR. DEEPTHI DECONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1030 PRESIDENT AVE, SUITE 110, FALL RIVER, MA 02720-5923
(508) 235-6349
(508) 973-1715
Mailing address
200 MILL RD, SUITE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
254999
MA
207RG0100X
Gastroenterology Physician
MD14439
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110096466A
—
MA
05
—
DD93883
—
RI
Enumeration date
04/21/2008
Last updated
04/21/2020
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