Individual
MONALI DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2349 LAKE AVE, SUITE 99, PLYMOUTH, IN 46563-7835
(574) 941-2977
(574) 941-2978
Mailing address
PO BOX 6309, SOUTH BEND, IN 46660-6309
(574) 335-8707
(574) 335-0750
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
12011
ND
207RC0000X
Cardiovascular Disease Physician
2008016699
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000861818
BCBS
IN
05
—
16044
—
ND
Enumeration date
07/10/2008
Last updated
04/03/2014
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