Individual
MICHAEL G DESAUTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
609 W HIGHLAND BLVD, INVERNESS, FL 34452-4638
(352) 726-9707
(352) 726-8763
Mailing address
12109 COUNTY ROAD 103, OXFORD, FL 34484-2951
(352) 205-8981
(352) 391-6498
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME78107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340016756
RAILROAD MEDICARE
FL
01
—
46851
BCBS FLORIDA
FL
Enumeration date
02/06/2006
Last updated
05/19/2021
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