Individual
DEEPAK DEV VIVEKANANDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE STE 710, GAINESVILLE, GA 30501-3715
(770) 219-9000
Mailing address
743 SPRING ST NE STE 710, GAINESVILLE, GA 30501-3715
(770) 219-8730
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13-3971298
EMPLOYER
—
Enumeration date
07/14/2020
Last updated
06/27/2023
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