Individual
DEEPTHI R MOSALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
711 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017
(859) 331-0774
(859) 578-3800
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 331-0774
(859) 578-3800
Taxonomy
Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
53087
KY
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
TP579
KY
207RC0000X
Cardiovascular Disease Physician
35087848
OH
207RC0000X
Cardiovascular Disease Physician
TP579
KY
207UN0901X
Nuclear Cardiology Physician
35087848
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2670631
—
OH
01
—
P01022280
RAILROAD MEDICARE
OH
Enumeration date
06/05/2006
Last updated
10/21/2021
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