Provider Demographics
NPI:1487895215
Name:DESAI, NITA M (MD)
Entity type:Individual
Prefix:DR
First Name:NITA
Middle Name:M
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W SOUTH BOULDER RD
Mailing Address - Street 2:STE 1
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1674
Mailing Address - Country:US
Mailing Address - Phone:303-444-1999
Mailing Address - Fax:303-443-1588
Practice Address - Street 1:333 W SOUTH BOULDER ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027
Practice Address - Country:US
Practice Address - Phone:303-444-1999
Practice Address - Fax:303-443-1588
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO32069207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine