Provider Demographics
NPI:1578721429
Name:BIPIN DESAI MD INC
Entity Type:Organization
Organization Name:BIPIN DESAI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:BIPIN
Authorized Official - Middle Name:MANHARIAL
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-382-3874
Mailing Address - Street 1:1125 ELLEN KAY DRIVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-2190
Mailing Address - Country:US
Mailing Address - Phone:740-382-3874
Mailing Address - Fax:740-382-2930
Practice Address - Street 1:1125 ELLEN KAY DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-2190
Practice Address - Country:US
Practice Address - Phone:740-382-3874
Practice Address - Fax:740-382-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350580172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0736001Medicaid
OH0680778Medicare PIN
OH0736001Medicaid