Provider Demographics
NPI:1073615878
Name:DESAI, REKHA J (MD)
Entity Type:Individual
Prefix:
First Name:REKHA
Middle Name:J
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:601 OLD NORCROSS RD
Mailing Address - Street 2:STE A
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4311
Mailing Address - Country:US
Mailing Address - Phone:770-963-2474
Mailing Address - Fax:770-963-2476
Practice Address - Street 1:601 OLD NORCROSS RD
Practice Address - Street 2:STE A
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4311
Practice Address - Country:US
Practice Address - Phone:770-963-2474
Practice Address - Fax:770-963-2476
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2011-02-16
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Provider Licenses
StateLicense IDTaxonomies
GA19665207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA19665OtherMD LICENSE
GA19665OtherMD LICENSE