Individual
MIT DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 E WOOD ST STE 401, SPARTANBURG, SC 29303-3040
(864) 560-6654
(864) 560-7353
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33801
SC
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
33801
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
338012
—
SC
01
—
AA92029068
MEDICARE PIN
SC
01
—
SCC0665019
MEDICARE PIN
SC
Enumeration date
06/11/2008
Last updated
12/21/2020
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