Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 2002019234 | MO |
Y | 204F00000X | Transplant Surgeon | D69702 | MD |
N | 208200000X | Surgeon | 2002019234 | MO |
N | 208600000X | Surgeon | 2002019234 | MO |
NPI | 1760400279 |
---|---|
Provider Name | Dr. Niraj M Desai |
First Address | Baltimore, MD 21264-4563 |
Second Address | Baltimore, MD 21287-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 17/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205888803 | (05) | MO |
418152200 | (05) | MD |
H69672 | (02) |