Individual
DR. TEJAS PRADEEP DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2355 W ARLINGTON BLVD, ECU PHYSICIANS NEPHROLOGY, GREENVILLE, NC 27834-2847
(252) 744-2545
(252) 744-4887
Mailing address
P.O. BOX 751069, ECU PHYSICIANS: MANAGED CARE DEPARTMENT, CHARLOTTE, NC 28275-1069
(252) 744-3258
(252) 744-3194
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
235462
NY
207RN0300X
Nephrology Physician
059062
GA
207RN0300X
Nephrology Physician
Primary
2009-01070
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
154PN
BCBSNC
NC
05
—
5913627
—
NC
01
—
P00789108
RAILROAD MEDICARE
NC
Enumeration date
01/17/2008
Last updated
11/29/2011
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