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Individual

DR. PRIYA SUDHAKAR DESHPANDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3614D J DEWEY GRAY CIR STE D, AUGUSTA, GA 30909-1806
(706) 868-7380
(706) 868-7223
Mailing address
PO BOX 2510, EVANS, GA 30809-2510
(706) 922-8251
(706) 650-9540

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049002
GA
207Q00000X
Family Medicine Physician
Primary
49002
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
049002
LICENSE
GA
05
0875916A
GA
01
10056076
AMERIGROUP
GA
01
336957
WELLCARE
GA
01
49002
GA MEDICAL LICENSE
GA
01
CH0654
RR MEDICARE GROUP PIN
GA
05
G49002
SC
Enumeration date
06/23/2006
Last updated
04/20/2026
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