Healthcare Provider Details

I. General information

NPI: 1992930192
Provider Name (Legal Business Name): CHIRAG SURESHCHANDRA DESAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW DEPARTMENT OF TRANSPLANT SURGERY
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

3800 RESERVOIR RD NW DEPARTMENT OF TRANSPLANT SURGERY
WASHINGTON DC
20007-2113
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-2600
  • Fax:
Mailing address:
  • Phone: 202-444-6396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberMD040632
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: