Healthcare Provider Details

I. General information

NPI: 1992721559
Provider Name (Legal Business Name): NIRMALA S DESAI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

2333 ALUMNI PARK PLZ STE 200
LEXINGTON KY
40517-4022
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5481
  • Fax:
Mailing address:
  • Phone: 859-218-5677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number16700
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: