Healthcare Provider Details

I. General information

NPI: 1104007665
Provider Name (Legal Business Name): ANAND BHARAT DESAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 07/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 N FORGE ST STE G90
AKRON OH
44304-1468
US

IV. Provider business mailing address

PO BOX 3542
AKRON OH
44309-3542
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3557
  • Fax: 330-376-1302
Mailing address:
  • Phone: 330-996-0347
  • Fax: 330-996-0359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35121141
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: