Healthcare Provider Details

I. General information

NPI: 1568023976
Provider Name (Legal Business Name): DEVASHISH DESAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7559
US

IV. Provider business mailing address

11 KIMBALL DR UNIT 125
HOOKSETT NH
03106-2623
US

V. Phone/Fax

Practice location:
  • Phone: 603-622-6484
  • Fax:
Mailing address:
  • Phone: 603-622-6484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberMT219071
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number34640
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: