Individual
ANISH A DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6002 PROFESSIONAL PKWY STE 200, DOUGLASVILLE, GA 30134
(678) 741-5000
(770) 874-0528
Mailing address
711 CANTON RD NE, SUITE 300, MARIETTA, GA 30060-8948
(678) 741-5000
(678) 819-4280
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
054483
GA
207RG0100X
Gastroenterology Physician
Primary
054483
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266365482A
—
GA
Enumeration date
02/08/2006
Last updated
05/31/2018
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