Provider Demographics
NPI:1396031308
Name:DESAI, NEIL KISHOR (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:KISHOR
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 1:2420 DOUBLE CHURCHES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2983
Mailing Address - Country:US
Mailing Address - Phone:706-324-7882
Mailing Address - Fax:706-324-7886
Practice Address - Street 1:35 COLLIER RD NW
Practice Address - Street 2:SUITE 635
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1613
Practice Address - Country:US
Practice Address - Phone:404-367-3014
Practice Address - Fax:404-367-3558
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA072540207R00000X
GA72540208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine