Basic Information
| Provider Information | |||||||||
| NPI: | 1336157122 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DESAI | ||||||||
| FirstName: | NILAY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7200 | ||||||||
| Address2: | |||||||||
| City: | ROCKY MOUNT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278040200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2529370200 | ||||||||
| FaxNumber: | 2524510056 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 N WINSTEAD AVE | ||||||||
| Address2: | |||||||||
| City: | ROCKY MOUNT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278048467 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2529370290 | ||||||||
| FaxNumber: | 2529373111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 03/08/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD426671 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | 2007-00007 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 1073315 | 01 | NC | RAILROAD MEDICARE | OTHER | 202535 | 01 | NC | MEDCOST | OTHER | 1320542 | 01 | NC | CIGNA | OTHER | 146H2 | 01 | NC | BCBS OF NC | OTHER | 2833434 | 01 | NC | UNITED HEALTH CARE | OTHER | 9015507 | 01 | NC | AETNA | OTHER | 5908042 | 05 | NC | MEDICAID |