Healthcare Provider Details

I. General information

NPI: 1073721700
Provider Name (Legal Business Name): MEGHA DESAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE ST ENDOCRINE CLINIC, 2ND FLOOR, WING C
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

800 ROSE ST DIV. OF ENDOCRINOLOGY, MEDICAL SCIENCE BLDG., MN 524
LEXINGTON KY
40536-0298
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-2232
  • Fax: 859-257-1078
Mailing address:
  • Phone: 859-323-5821
  • Fax: 859-323-5707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number41459
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number41459
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: