Individual
SUVAS GHELABHAI DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 MARIE LANGDON DR, MANCHESTER, KY 40962-6329
(606) 598-5104
(606) 598-1688
Mailing address
56 MARIE LANGDON DR, MANCHESTER, KY 40962-6329
(606) 598-5104
(606) 598-0983
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
208800000X
Urology Physician
Primary
16723
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045887
ANTHEM
KY
05
—
64167232
—
KY
Enumeration date
09/23/2005
Last updated
04/01/2021
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