Provider Demographics
NPI:1659550630
Name:DESAI & HOLMES,M.D,LLC
Entity Type:Organization
Organization Name:DESAI & HOLMES,M.D,LLC
Other - Org Name:DESAI,HOLMES & SHEER,MD,LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PANKAJ
Authorized Official - Middle Name:ROHIT
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACP
Authorized Official - Phone:410-356-1575
Mailing Address - Street 1:90 PAINTERS MILL RD STE 205
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3614
Mailing Address - Country:US
Mailing Address - Phone:410-356-1575
Mailing Address - Fax:410-363-6840
Practice Address - Street 1:90 PAINTERS MILL RD STE 205
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3614
Practice Address - Country:US
Practice Address - Phone:410-356-1575
Practice Address - Fax:410-363-6840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040390207R00000X
MDDOO47206207R00000X
MDD0010246207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD270299Medicaid
MD527921600Medicaid
MD270301Medicaid
MD365451600Medicaid
MD089311100Medicaid
MD157500700Medicaid
MD270300Medicaid
MD270299Medicaid
MD157500700Medicaid
MD270300Medicaid
MD089311100Medicaid
MDE46853Medicare UPIN
MDG01174Medicare UPIN
MD527921600Medicaid