Provider Demographics
NPI:1013414861
Name:DESIKAN, SAI PRASAD (MD)
Entity type:Individual
Prefix:
First Name:SAI PRASAD
Middle Name:
Last Name:DESIKAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 MOUNTAIN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-8545
Mailing Address - Country:US
Mailing Address - Phone:501-773-6408
Mailing Address - Fax:
Practice Address - Street 1:1830 E MONUMENT ST STE 416
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0020
Practice Address - Country:US
Practice Address - Phone:443-927-3140
Practice Address - Fax:410-367-2258
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program