Provider Demographics
NPI:1730277054
Name:DESHPANDE, KAMALINEE V
Entity type:Individual
Prefix:DR
First Name:KAMALINEE
Middle Name:V
Last Name:DESHPANDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 LUX LANE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3501
Mailing Address - Country:US
Mailing Address - Phone:301-493-6866
Mailing Address - Fax:301-493-6867
Practice Address - Street 1:6001 LUX LANE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3501
Practice Address - Country:US
Practice Address - Phone:301-493-6866
Practice Address - Fax:301-493-6867
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020415174400000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD200056642OtherTAX ID