Individual
DEEPTHI SEEKURI MANOJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1900 E LAKE SHORE DR, DECATUR, IL 62521-3824
(217) 423-2889
Mailing address
1900 E LAKE SHORE DR, DECATUR, IL 62521-3824
(217) 423-2889
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036138351
IL
284300000X
Special Hospital
—
—
Other
Enumeration date
03/06/2013
Last updated
07/14/2015
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