Provider Demographics
NPI:1275551061
Name:DESAI, RAHUL NAREN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:NAREN
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 SW NIMBUS AVE
Mailing Address - Street 2:150
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7478
Mailing Address - Country:US
Mailing Address - Phone:503-535-8302
Mailing Address - Fax:503-416-8732
Practice Address - Street 1:8950 SW NIMBUS AVE
Practice Address - Street 2:150
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7478
Practice Address - Country:US
Practice Address - Phone:503-535-8302
Practice Address - Fax:503-416-8732
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-01-28
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2008-10-22
Provider Licenses
StateLicense IDTaxonomies
OH35.0835612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI54850Medicare UPIN
OHI5485Medicare UPIN