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General NPI Number Information
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NPI Number | 1548503543
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Entity Type | Individual
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Provider Name | LEKHA KOPPOLU DESAI MD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 4414 LAKE BOONE TRL STE 302
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City | RALEIGH
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State | NC
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Zip | 27607-7514
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Country | US
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Telephone | 919-782-8038
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Fax |
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Provider Business Mailing Address
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Address Line | 4414 LAKE BOONE TRL STE 302
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City | RALEIGH
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State | NC
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Zip | 27607-7514
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Country | US
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Telephone | 919-782-8038
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A148705
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 25MA10541500
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License Number State | NJ
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Taxonomy #3
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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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 2024-01714
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License Number State | NC
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