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Individual

MR. TEJAS RAMESH DESAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
25401 75TH ST, SALEM, WI 53168-9527
(262) 843-1550
Mailing address
25401 75TH ST, SALEM, WI 53168-9527
(262) 843-1550

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
051.292884
IL
183500000X
Pharmacist
Primary
14194-040
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051.292884
LICENSE NUMBER
IL
01
14194-040
LICENSE NUMBER
WI
Enumeration date
11/25/2011
Last updated
11/25/2011
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