Pandraju, Deepthi
Pandraju, Deepthi is an individual health care provider with primary practice located at 104 Whalon St Ste 2A , Fitchburg MA 01420-7128. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pandraju, Deepthi can be contacted via phone (978) 345-1700.Contact Information
Primary practice address
104 Whalon St Ste 2A
Fitchburg MA 01420-7128
Phone: (978) 345-1700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 6518 | Kansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 242397 | Massachusetts |
Profile Details
| NPI number | 1073734901 |
|---|---|
| LBN Legal business name | Pandraju, Deepthi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2007 |
| Last updated | Dec 14th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073734901 | NPPES |
| Massachusetts | Other | M20928 | GROUP PIN |
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