Individual
DR. RUCHIK S DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3190 LANCER ST, PORTAGE, IN 46368-4408
(219) 764-3600
(219) 764-3661
Mailing address
3190 LANCER ST, PORTAGE, IN 46368-4408
(219) 764-3600
(219) 764-3661
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01057862A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000350979
ANTHEM
IN
Enumeration date
10/10/2005
Last updated
09/05/2014
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