Provider Demographics
NPI:1134197163
Name:DESAI, BHARATI A (MD)
Entity type:Individual
Prefix:MRS
First Name:BHARATI
Middle Name:A
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 ROCKY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-5940
Mailing Address - Country:US
Mailing Address - Phone:330-864-4026
Mailing Address - Fax:330-836-1109
Practice Address - Street 1:931 ROCKY RIDGE DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-5940
Practice Address - Country:US
Practice Address - Phone:330-864-4026
Practice Address - Fax:330-836-1109
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 . 040932207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0343551Medicaid
OHBH0818753Medicare ID - Type Unspecified
OHDE0818752Medicare ID - Type Unspecified
OH0343551Medicaid