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General NPI Number Information
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NPI Number | 1457770216
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Entity Type | Individual
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Provider Name | NISHANT DESAI
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Gender | Male
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Dates
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Enumeration Date | 04/09/2014
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 9221 STONY CREST CIR APT 325
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City | RICHMOND
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State | VA
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Zip | 23235-6894
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Country | US
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Telephone | 248-561-8373
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Fax |
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Provider Business Mailing Address
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Address Line | 9221 STONY CREST CIR APT 325
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City | RICHMOND
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State | VA
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Zip | 23235-6894
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0116031482
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 0116031482
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License Number State | VA
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