Provider Demographics
NPI:1508048802
Name:DESAI, NIRAJ N (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:N
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1034 HAW CREEK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6513
Mailing Address - Country:US
Mailing Address - Phone:678-381-2020
Mailing Address - Fax:678-381-2015
Practice Address - Street 1:1034 HAW CREEK CIR STE 100
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6513
Practice Address - Country:US
Practice Address - Phone:678-381-2020
Practice Address - Fax:678-381-2015
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2023-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA107685207W00000X
GA69159207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABX641XMedicare PIN