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General NPI Number Information
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NPI Number | 1679593909
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Entity Type | Individual
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Provider Name | BIJAL DESAI M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 309 W BUTLER RD
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City | MAULDIN
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State | SC
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Zip | 29662-2531
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Country | US
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Telephone | 864-297-1575
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Fax | 877-817-1801
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Provider Business Mailing Address
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Address Line | PO BOX 639856
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City | CINCINNATI
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State | OH
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Zip | 45263-9856
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101250322
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL29227
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License Number State | SC
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