MEDICARE: KARTIK J 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	174400000X	Specialist	D0062704	MD
2	207R00000X	Internal Medicine Physician	D0062704	MD

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	:	1881730067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARTIK J DESAI MD

Provider Business Mailing Address
First Line	:	3290 N RIDGE RD
Second Line	:	SUITE 100
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-3655
Country	:	US
Telephone Number	:	410-313-9292
Fax Number	:	410-313-9293

Provider Business Practice Location Address
First Line	:	3290 N RIDGE RD
Second Line	:	SUITE 100
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-3655
Country	:	US
Telephone Number	:	410-313-9292
Fax Number	:	410-313-9293

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	03/27/2019

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Directions to “ KARTIK J DESAI MD” Practice Location

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