Provider Demographics
NPI:1548258924
Name:DESAI, ROHIT MANUBHAI (MD)
Entity type:Individual
Prefix:DR
First Name:ROHIT
Middle Name:MANUBHAI
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1183 S HAIRSTON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-2796
Mailing Address - Country:US
Mailing Address - Phone:404-296-8858
Mailing Address - Fax:404-296-8941
Practice Address - Street 1:1183 S HAIRSTON RD
Practice Address - Street 2:SUITE A
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-2796
Practice Address - Country:US
Practice Address - Phone:404-296-8858
Practice Address - Fax:404-296-5599
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2013-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA030594207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000412794BMedicaid
GA08BDBQHMedicare ID - Type Unspecified
GAA77964Medicare UPIN