Individual
TEJAL HARESH DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
2171 WEST PARK COURT, SUITE A, STONE MOUNTAIN, GA 30087-3555
(678) 514-2640
Mailing address
2171 WEST PARK COURT, SUITE A, STONE MOUNTAIN, GA 30087-3555
(678) 514-2640
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
003950
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00591324J
—
GA
Enumeration date
01/05/2007
Last updated
05/03/2008
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