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General NPI Number Information
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NPI Number | 1841350949
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Entity Type | Individual
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Provider Name | SHOBHANA A. DESAI MD
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Gender | Female
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | THOMAS JEFFERSON UNIVERSITY HOSPITAL 111 S. 11TH STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4824
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Country | US
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Telephone | 215-955-6000
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Fax | 215-923-9519
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Provider Business Mailing Address
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Address Line | NEMOURS CHILDRENS CLINIC P.O. BOX 404112
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City | ATLANTA
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State | GA
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Zip | 30384-0001
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Country | US
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Telephone | 904-390-3610
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Fax | 904-288-5890
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | MD035125L
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License Number State | PA
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