Provider Demographics
NPI:1477105211
Name:DESAI & SHROFF MEDICAL
Entity Type:Organization
Organization Name:DESAI & SHROFF MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GEN PTR
Authorized Official - Prefix:
Authorized Official - First Name:SAURABH
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-949-0555
Mailing Address - Street 1:6025 PROFESSIONAL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-5610
Mailing Address - Country:US
Mailing Address - Phone:770-949-0555
Mailing Address - Fax:770-949-4424
Practice Address - Street 1:6025 PROFESSIONAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5610
Practice Address - Country:US
Practice Address - Phone:770-949-0555
Practice Address - Fax:770-949-4424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty