Individual
KETKI DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0006
(706) 721-7000
Mailing address
3875 MANHASSETT PL NE, MARIETTA, GA 30066-3090
(404) 917-4176
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
104936
GA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/22/2021
Last updated
10/15/2025
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