Individual
DR. SAURABH DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 W STONE DR, SUITE 100, KINGSPORT, TN 37660-6027
(423) 247-5197
(423) 247-5254
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
49363
TN
207RP1001X
Pulmonary Disease Physician
Primary
49363
TN
208M00000X
Hospitalist Physician
49363
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366682171
—
NC
05
—
1366682171
—
VA
05
—
7100262890
—
KY
01
—
P01291987
RR MEDICARE
TN
05
—
Q000223
—
TN
Enumeration date
03/06/2009
Last updated
11/10/2015
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