Individual
MR. DEEPAK SEBASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
20319 FARMINGTON RD BLDG E, LIVONIA, MI 48152-1411
(248) 476-8911
(248) 476-8913
Mailing address
20319 FARMINGTON RD BLDG E, LIVONIA, MI 48152-1411
(248) 476-8911
(248) 476-8913
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005163
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383454355
ALTERNATIVE REHAB TAX ID
MI
01
—
383606482
INSPIRATIONS TAX ID
MI
01
—
650H202760
BCBS INDIVIDUAL PIN
MI
01
—
650H217590
BCBS GROUP PIN
MI
Enumeration date
12/08/2006
Last updated
01/31/2013
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