| Doctor Name: | DR. IRIS DEODORICO |
| NPI Number: | 1245282771 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 4301062556 |
| Business Practice Address: | 1535 Gull Rd Suite 200 Kalamazoo, MI - 490481650 |
| Business Phone Number: | 2693886350 |
| Business Fax Number: | 2693884738 |
| Mailing Address: | 1535 Gull Rd, Suite 200 KALAMAZOO |
| State: | MI |
| Postal Code: | 490481650 |
| Phone Number: | 2693886350 |
| Fax Number: | 2693884738 |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 4301062556 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |