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Individual

DR. PRAMTHESH KANTILAL DESAI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
545 N RIVER ST, SUITE 40, WILKES BARRE, PA 18702-2600
(570) 270-4480
(866) 448-4667
Mailing address
545 N RIVER ST, SUITE 40, WILKES BARRE, PA 18702-2600
(570) 270-4480
(866) 448-4667

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD067122L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019661130002
PA
01
12315DOL
RENDERING DOCTOR FOR PRIME MED
PA
Enumeration date
05/20/2006
Last updated
04/28/2008
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