Provider Demographics
NPI:1114000767
Name:DESAI, AASHISH KIRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AASHISH
Middle Name:KIRAN
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:900 TOWNE LAKE PKWY
Mailing Address - Street 2:STE 400
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-1604
Mailing Address - Country:US
Mailing Address - Phone:404-921-0638
Mailing Address - Fax:
Practice Address - Street 1:460 NORTHSIDE CHEROKEE BLVD STE 190
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8018
Practice Address - Country:US
Practice Address - Phone:470-639-6250
Practice Address - Fax:770-345-0712
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2020-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA052165207RC0000X
FLTRN8397207RC0000X
GA52165207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH95647Medicare UPIN