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Individual

MR. ANIL J DESAI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4139 BAKER ST NE, COVINGTON, GA 30014-1405
(770) 786-9499
(770) 786-9757
Mailing address
3641 HIGHWAY 20 SE, SUITE A, CONYERS, GA 30013-3064
(770) 918-1234
(770) 918-1235

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
035033
GA
207RH0003X
Hematology & Oncology Physician
Primary
035033
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00588266C
GA
Enumeration date
08/23/2006
Last updated
02/25/2016
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