Individual
DR. PRAMOD MADHUKAR DESHMUKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
(570) 887-2882
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
164983-1
NY
207RC0000X
Cardiovascular Disease Physician
Primary
MD042000L
PA
207RC0001X
Clinical Cardiac Electrophysiology Physician
164983-1
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
MD042000L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012135320001
—
PA
05
—
01206711
—
NY
01
—
060060323
RR MEDICARE PIN
PA
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039823
MEDICARE GROUP
PA
Enumeration date
02/22/2006
Last updated
01/12/2015
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