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1144216318

NPI Code Detail

MEDICARE: SUVAS GHELABHAI DESAI MD

MEDICARE: SUVAS GHELABHAI DESAI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist
2	208800000X	Urology Physician	16723	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000045887	OTHER	KY	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144216318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUVAS GHELABHAI DESAI MD

Provider Business Mailing Address
First Line	:	56 MARIE LANGDON DR
Second Line	:
City	:	MANCHESTER
State	:	KY
Zip	:	40962-6329
Country	:	US
Telephone Number	:	606-598-5104
Fax Number	:	606-598-0983

Provider Business Practice Location Address
First Line	:	56 MARIE LANGDON DR
Second Line	:
City	:	MANCHESTER
State	:	KY
Zip	:	40962-6329
Country	:	US
Telephone Number	:	606-598-5104
Fax Number	:	606-598-1688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	04/01/2021

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Directions to “ SUVAS GHELABHAI DESAI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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