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Individual

DR. BIJAL DESAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
309 W BUTLER RD, MAULDIN, SC 29662-2531
(864) 297-1575
(877) 817-1801
Mailing address
PO BOX 639856, CINCINNATI, OH 45263-9856

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101250322
VA
207R00000X
Internal Medicine Physician
Primary
LL29227
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101250322
LISENCE
VA
05
0101250322
VA
01
29227
STATE LICENSE
SC
05
292276
SC
Enumeration date
07/20/2006
Last updated
11/21/2023
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