Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | TP339 | KY |
NPI | 1457618829 |
---|---|
Provider Name | Dr. Siddharth Niranjan Desai |
First Address | Lexington, KY 40536-0284 |
Second Address | Lexington, KY 40536-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2012 |
Last Update Date | 22/07/2020 |