Provider Demographics
NPI:1710950720
Name:DESAI, YOGESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:YOGESH
Middle Name:K
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 1:146 MARION AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-2201
Mailing Address - Country:US
Mailing Address - Phone:419-526-2655
Mailing Address - Fax:419-526-1107
Practice Address - Street 1:146 MARION AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2201
Practice Address - Country:US
Practice Address - Phone:419-526-2655
Practice Address - Fax:419-526-1107
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350638592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0899407Medicaid
A60588Medicare UPIN
DE0728571Medicare ID - Type Unspecified