MEDICARE: DR. SHIRIN RAMANI DESILVA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	E4074	AR
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	2006017539	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295793818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIRIN RAMANI DESILVA MD

Provider Business Mailing Address
First Line	:	4600 MERCY LN STE 240
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-3070
Country	:	US
Telephone Number	:	479-347-3812
Fax Number	:	479-347-3678

Provider Business Practice Location Address
First Line	:	4600 MERCY LN STE 240
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-3070
Country	:	US
Telephone Number	:	479-347-3812
Fax Number	:	479-347-3678

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	11/06/2025

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