Provider Demographics
NPI:1063478311
Name:DESAI, AKSHAY SUVAS (MD)
Entity Type:Individual
Prefix:
First Name:AKSHAY
Middle Name:SUVAS
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:75 FRANCIS STREET PBB1
Mailing Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL CARDIOVASCULAR DIVISION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-525-7052
Mailing Address - Fax:617-264-5265
Practice Address - Street 1:75 FRANCIS STREET PBB1
Practice Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL CARDIOVASCULAR DIVISION
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:857-307-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA205262207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEA3645802Medicare PIN