Individual
DR. PRATIKKUMAR VRAJESHBHAI DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548
(616) 455-5000
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301113836
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891113171
—
MI
Enumeration date
04/03/2014
Last updated
11/17/2022
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