Provider Demographics
NPI:1831180769
Name:DESAI, NEEL C (MD)
Entity type:Individual
Prefix:DR
First Name:NEEL
Middle Name:C
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-341-3114
Mailing Address - Fax:859-578-2156
Practice Address - Street 1:2300 CHAMBER CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017
Practice Address - Country:US
Practice Address - Phone:859-341-3114
Practice Address - Fax:859-578-2156
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY39014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64085061Medicaid
OH2663916Medicaid
KYP00326678Medicare PIN
KYI14583Medicare UPIN
OH2663916Medicaid