Individual
DEEPAK JASUJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 375-0272
(812) 375-1093
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01065199A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000991154
ANTHEM PIN
IN
05
—
200911610
—
IN
Enumeration date
02/20/2008
Last updated
09/09/2024
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