Provider Demographics
NPI:1174768956
Name:DESAI, NISARG R (MD)
Entity type:Individual
Prefix:
First Name:NISARG
Middle Name:R
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18947 JOHN J WILLIAMS HWY UNIT 101
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4480
Mailing Address - Country:US
Mailing Address - Phone:302-645-3770
Mailing Address - Fax:302-645-5718
Practice Address - Street 1:18947 JOHN J WILLIAMS HWY UNIT 101
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4480
Practice Address - Country:US
Practice Address - Phone:302-645-3770
Practice Address - Fax:302-645-5718
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0011772207RH0003X
IL036135536207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology