Individual
MANOJ R. DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
717 W XENIA DR, FAIRBORN, OH 45324-4930
(937) 878-4531
(937) 878-4070
Mailing address
717 W XENIA DR, FAIRBORN, OH 45324-4930
(937) 878-4531
(937) 878-4070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35041371
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387039
ANTHEM
OH
05
—
0347879
—
OH
01
—
311358549060
CARESOURCE
OH
01
—
4242852
AETNA
—
Enumeration date
06/09/2006
Last updated
11/30/2007
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