Provider Demographics
NPI:1992795009
Name:DESAI, SHEKHAR S (MD)
Entity type:Individual
Prefix:
First Name:SHEKHAR
Middle Name:S
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1223 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2607
Mailing Address - Country:US
Mailing Address - Phone:321-952-4445
Mailing Address - Fax:321-952-3081
Practice Address - Street 1:5200 BABCOCK ST NE
Practice Address - Street 2:SUITE 111
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4612
Practice Address - Country:US
Practice Address - Phone:321-952-4445
Practice Address - Fax:321-952-3081
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2010-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME59178207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL200037431OtherRR MEDICARE
FL4339774OtherAETNA
FL053065400Medicaid
FL4234237004OtherCIGNA
FL12128OtherBCBS
FL053065400Medicaid
FL200037431OtherRR MEDICARE