Individual
ABHILASH DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
413 N ALLUMBAUGH ST STE 101, BOISE, ID 83704-9219
(208) 323-1125
(208) 323-9604
Mailing address
413 N ALLUMBAUGH ST, STE 101, BOISE, ID 83704-9219
(617) 922-4957
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M-12079
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366519084
—
ID
Enumeration date
11/29/2006
Last updated
09/22/2016
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