Organization
KULDIP S. DEOGUN, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KULDIP S. DEOGUN M.D. (PRESIDENT)
(586) 997-5048
Entity
Organization
Contact information
Practice address
43145 SCHOENHERR RD, UNIT #13, STERLING HEIGHTS, MI 48313-1955
(586) 997-5048
(586) 997-5049
Mailing address
PO BOX 33747, DEPT 999437, DETROIT, MI 48232-3747
(248) 543-8070
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050E021260
BCBS GROUP NUMBER
MI
05
—
4840071
—
MI
Enumeration date
05/31/2006
Last updated
01/09/2019
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