Provider Demographics
NPI:1629399035
Name:DESAI, RAVI YOGESHKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:YOGESHKUMAR
Last Name:DESAI
Suffix:
Gender:M
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:PO BOX 933242
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0035
Mailing Address - Country:US
Mailing Address - Phone:937-439-3600
Mailing Address - Fax:937-439-3786
Practice Address - Street 1:4000 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3908
Practice Address - Country:US
Practice Address - Phone:937-439-3600
Practice Address - Fax:937-439-3786
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT196339207R00000X
PAMD449218207R00000X
OH35-127721207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0162690Medicaid
OHP01655476Medicare PIN
OHH469650Medicare PIN