Individual
DR. DEEPA BAI JAGTAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3577 W 13 MILE RD, SUITE 103, ROYAL OAK, MI 48073-6710
(248) 288-4500
(248) 288-0450
Mailing address
3577 W 13 MILE RD, SUITE 103, ROYAL OAK, MI 48073-6710
(248) 288-4500
(248) 288-0450
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301087460
MI
207RH0003X
Hematology & Oncology Physician
Primary
4301087460
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629190095
—
MI
01
—
700H273300
BLUE SHIELD
MI
Enumeration date
04/04/2007
Last updated
07/21/2022
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