Provider Demographics
NPI:1588636971
Name:DESAI, VARSHA J (MD)
Entity Type:Individual
Prefix:
First Name:VARSHA
Middle Name:J
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:16 WALNUT AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4719
Mailing Address - Country:US
Mailing Address - Phone:540-345-6468
Mailing Address - Fax:540-345-3204
Practice Address - Street 1:16 WALNUT AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4719
Practice Address - Country:US
Practice Address - Phone:540-345-6468
Practice Address - Fax:540-345-3204
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2021-07-06
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Provider Licenses
StateLicense IDTaxonomies
VA0101-031753208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006747451Medicaid
VA1588636971Medicaid
VA006747451Medicaid
VA1588636971Medicaid