Individual
DR. KETAN M DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 S NEW BALLAS RD STE 7063, SAINT LOUIS, MO 63141-8218
(314) 251-4200
(314) 251-5816
Mailing address
625 S NEW BALLAS RD STE 7063, SAINT LOUIS, MO 63141-8218
(314) 251-4200
(314) 251-5816
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2001015133
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285759985
—
MO
01
—
P01112373
RAILROAD MEDICARE
MO
Enumeration date
03/20/2007
Last updated
03/31/2025
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