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1356600662

NPI Code Detail

MEDICARE: DR. NIKITA DESAI MD

MEDICARE: DR. NIKITA DESAI 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	207R00000X	Internal Medicine Physician	1356600662	OH
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	2020-03963	NC
3	207RP1001X	Pulmonary Disease Physician	2020-03963	NC

General Provider Information

NPI Number	:	1356600662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIKITA DESAI MD

Provider Business Mailing Address
First Line	:	3511 W MARKET ST STE 100
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27403-4444
Country	:	US
Telephone Number	:	336-522-8999
Fax Number	:	336-522-8998

Provider Business Practice Location Address
First Line	:	3511 W MARKET ST STE 100
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27403-4444
Country	:	US
Telephone Number	:	336-522-8999
Fax Number	:	336-522-8998

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

Provider Enumeration Date	:	05/07/2012
Last Update Date	:	01/15/2021

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Directions to “ DR. NIKITA DESAI MD” Practice Location

Language	Start Address	Practice Location

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