Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 2014008229 | MO |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | D79917 | MD |
NPI | 1700013521 |
---|---|
Provider Name | Dr. Shaun Chandra Desai |
First Address | Bethesda, MD 20817-7837 |
Second Address | Bethesda, MD 20817-7837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 14/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
097422600 | (05) | MD |