Provider Demographics
NPI:1013153014
Name:DESAI, HIMANSHU D (MD)
Entity type:Individual
Prefix:
First Name:HIMANSHU
Middle Name:D
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 KINGSBOROUGH SQ STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4999
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:300 MEDICAL PKWY STE 222A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4985
Practice Address - Country:US
Practice Address - Phone:757-917-5716
Practice Address - Fax:757-524-4396
Is Sole Proprietor?:No
Enumeration Date:2008-12-21
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246880207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherUSA MANAGED CARE
VA1013153014Medicaid
VAPAROtherCORVEL/CORCARE (EVMS HEALTH SERVICES)
VAPAROtherVA PREMIER HEALTH (EVMS HEALTH SERVICES)
VAPAROtherMULTIPLAN NETWORK (EVMS HEALTH SERVICES)
VAPAROtherAETNA
VA10060446OtherOPTIMA HEALTH
VAPAROtherFIRST HEALTH COMMERCIAL/COVENTRY HEALTH/SOUTHERN HEALTH
VA-029OtherTRICARE/CHAMPUS
NC5914867Medicaid
VAPAROtherUNITED HEALTH CARE/MAMSI
VAPAROtherCIGNA
VA408336OtherANTHEM BC/BS
VAPAROtherVIRGINIA HEALTH NETWORK
VAP00855158Medicare PIN
VAPAROtherUSA MANAGED CARE