Organization
DEEPTHI S CULL MD PA
Active
Other names
Avant-Garde Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPTHI S CULL MD (PRESIDENT)
(847) 767-0137
Entity
Organization
Contact information
Practice address
116 EDDIE DOWLING HWY, NORTH SMITHFIELD, RI 02896-7327
(401) 769-2200
Mailing address
4225 LINCOLNSHIRE DR STE B, MOUNT VERNON, IL 62864-2157
(618) 242-2317
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/04/2021
Last updated
09/09/2022
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