Provider Demographics
NPI:1376542936
Name:DESAI, ABHIJIT N (MD)
Entity Type:Individual
Prefix:
First Name:ABHIJIT
Middle Name:N
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 1:3301 MERCY HEALTH BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-1106
Mailing Address - Country:US
Mailing Address - Phone:513-215-9200
Mailing Address - Fax:513-215-9259
Practice Address - Street 1:3301 MERCY HEALTH BLVD STE 125
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1106
Practice Address - Country:US
Practice Address - Phone:513-215-9200
Practice Address - Fax:513-215-9259
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.056320207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2105653Medicaid
IN200233350Medicaid
KY64009046Medicaid
E83603Medicare UPIN
IN200233350Medicaid
OH4154647Medicare PIN