Provider Demographics
NPI:1497084685
Name:DESAI, SARLA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SARLA
Middle Name:M
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 COUNTRY SIDE LN
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7940
Mailing Address - Country:US
Mailing Address - Phone:724-935-6982
Mailing Address - Fax:
Practice Address - Street 1:2548 COUNTRY SIDE LN
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7940
Practice Address - Country:US
Practice Address - Phone:724-935-6982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-018413-E208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE88995Medicare UPIN