Healthcare Provider Details

I. General information

NPI: 1578583324
Provider Name (Legal Business Name): VARSHA DESAI, M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 CALUMET AVE
MUNSTER IN
46321-1753
US

IV. Provider business mailing address

8230 CALUMET AVE
MUNSTER IN
46321-1753
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-2232
  • Fax: 219-836-3423
Mailing address:
  • Phone: 219-836-2232
  • Fax: 219-836-3423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number01028515
License Number StateIN

VIII. Authorized Official

Name: DR. VARSHA A DESAI
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 219-836-2232