MEDICARE: NITIN R DESAI MD PC

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	042810	GA

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

General Provider Information

NPI Number	:	1376651216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NITIN R DESAI MD PC

Provider Business Mailing Address
First Line	:	2410 DOUBLE CHURCHES RD.
Second Line	:	SUITE A
City	:	COLUMBUS
State	:	GA
Zip	:	31909
Country	:	US
Telephone Number	:	706-576-4600
Fax Number	:	706-576-4509

Provider Business Practice Location Address
First Line	:	2410 DOUBLE CHURCHES RD.
Second Line	:	SUITE A
City	:	COLUMBUS
State	:	GA
Zip	:	31909
Country	:	US
Telephone Number	:	706-576-4600
Fax Number	:	706-576-4509

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NITIN R. DESAI
Credential	:	M.D.
Telephone Number	:	706-576-4600

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	10/29/2010

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