Individual
DR. SHREYAS ARVIND DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2640 HAMSTROM RD, PORTAGE, IN 46368-3832
(219) 762-9523
(219) 763-3120
Mailing address
2640 HAMSTROM RD, PORTAGE, IN 46368-3832
(219) 762-9523
(219) 763-3120
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
01027933A
IN
207R00000X
Internal Medicine Physician
Primary
01027933A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100157480A
—
IN
05
—
200201230
—
IN
Enumeration date
06/01/2005
Last updated
08/09/2016
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