Healthcare Provider Details

I. General information

NPI: 1467147009
Provider Name (Legal Business Name): KHUSHI JATINBHAI DESAI MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W 13 MILE RD
ROYAL OAK MI
48073-6712
US

IV. Provider business mailing address

3535 W 13 MILE RD STE 344
ROYAL OAK MI
48073-6770
US

V. Phone/Fax

Practice location:
  • Phone: 313-436-2577
  • Fax: 313-436-2756
Mailing address:
  • Phone: 248-551-0497
  • Fax: 248-551-4556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4351050928
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: