Provider Demographics
NPI:1386820876
Name:DESAI, CHIRAG V (MD)
Entity Type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:V
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10140 CENTURION PARKWAY N
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPARTMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0532
Mailing Address - Country:US
Mailing Address - Phone:904-697-4127
Mailing Address - Fax:904-697-5102
Practice Address - Street 1:807 CHILDRENS WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8426
Practice Address - Country:US
Practice Address - Phone:904-697-3600
Practice Address - Fax:904-697-3927
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2022-07-21
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2361102084P0800X
FLME1035682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH334ZMedicare PIN