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General NPI Number Information
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NPI Number | 1679866842
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Entity Type | Individual
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Provider Name | DEVARSHI J DESAI M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2011
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 800 OAK RIDGE TPKE STE A101
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City | OAK RIDGE
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State | TN
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Zip | 37830-6958
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Country | US
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Telephone | 865-483-1093
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Fax |
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Provider Business Mailing Address
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Address Line | 611 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2501
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Country | US
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Telephone | 217-383-6941
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D0080840
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036142504
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License Number State | IL
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