Provider Demographics
NPI:1457517716
Name:DESAI, NIMESH D (MD)
Entity Type:Individual
Prefix:
First Name:NIMESH
Middle Name:D
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 SPRUCE ST
Mailing Address - Street 2:6 SILVERSTEIN
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4206
Mailing Address - Country:US
Mailing Address - Phone:215-615-4949
Mailing Address - Fax:215-349-5798
Practice Address - Street 1:3400 CIVIC CENTER BOULEVARD
Practice Address - Street 2:WEST PAVILLION-1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-615-4949
Practice Address - Fax:215-349-5798
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2013-12-09
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Provider Licenses
StateLicense IDTaxonomies
PAMD434135208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADG1992Medicare UPIN