Provider Demographics
NPI:1699802033
Name:DESAI, SANGEETA A (MD)
Entity type:Individual
Prefix:
First Name:SANGEETA
Middle Name:A
Last Name:DESAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SANGEETA
Other - Middle Name:D
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8209 GAINSBOROUGH CT W
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4273
Mailing Address - Country:US
Mailing Address - Phone:202-877-9696
Mailing Address - Fax:202-877-9263
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:SUITE NA1177
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-9696
Practice Address - Fax:202-877-9263
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD31025207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCJ879 0001OtherBLUE SHIELD
MD758599 02OtherBLUE SHIELD
DCJ879 0001OtherBLUE SHIELD
DC000P07M32Medicare PIN