Healthcare Provider Details

I. General information

NPI: 1437282514
Provider Name (Legal Business Name): RAJIV HASMUKHRAY DESAI P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 N WEBER ST SUITE # 220
COLORADO SPRINGS CO
80907-7532
US

IV. Provider business mailing address

1715 N WEBER ST SUITE # 220
COLORADO SPRINGS CO
80907-7532
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-3246
  • Fax: 719-471-0113
Mailing address:
  • Phone: 719-471-3246
  • Fax: 719-471-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number40929
License Number StateCO

VIII. Authorized Official

Name: DR. RAJIV H DESAI
Title or Position: SURGEON
Credential: MD
Phone: 719-471-3246