MEDICARE: CHANDRAKANT C 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	2084N0400X	Neurology Physician	4301041537	MI

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	:	1699726919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDRAKANT C DESAI MD

Provider Business Mailing Address
First Line	:	43902 WOODWARD AVE STE 100
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5021
Country	:	US
Telephone Number	:	248-955-9949
Fax Number	:	248-928-2274

Provider Business Practice Location Address
First Line	:	43902 WOODWARD AVE STE 100
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-5021
Country	:	US
Telephone Number	:	248-955-9949
Fax Number	:	489-282-2742

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

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/23/2024

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