Individual
DEEPAK DAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 OGLETHORPE AVE, SUITE NUMBER 3100, ATHENS, GA 30606-2179
(706) 850-6383
(706) 850-6389
Mailing address
1500 OGLETHORPE AVE, 3100, ATHENS, GA 30606-2179
(706) 850-6383
(706) 850-6389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
059704
GA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
059704
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059704
STATE LICENSE
GA
01
—
1366695835
GROUP NPI NUMBER
GA
01
—
263323412
FEDERAL TAX ID
GA
Enumeration date
08/10/2005
Last updated
03/07/2023
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