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Individual

PRAVEEN DESHMUKH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3615 NW SAMARITAN DR STE 210, CORVALLIS, OR 97330-3771
(541) 768-4501
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
43578
WI
207T00000X
Neurological Surgery Physician
Primary
MD176134
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500701512
OR
Enumeration date
03/01/2006
Last updated
01/26/2021
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