Woodward Gastroenterology PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

4301044285 Issued in MI

Legal business name

WOODWARD GASTROENTEROLOGY PC

Practice address

1695 12 Mile Rd
Suite 220
Berkley, MI 48072-2182

Phone

(248) 229-8354

NPI assigned

Dec 23, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tusar Kishore Desai, MD

Title

Owner

Phone

(248) 229-8354

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1104247899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 CLUB DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020907",
            "telephone_number": "248-229-8354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 12 MILE RD",
            "address_2": "SUITE 220",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722182",
            "telephone_number": "248-229-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWARD GASTROENTEROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-23",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "TUSAR",
        "authorized_official_middle_name": "KISHORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-229-8354",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "4301044285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willow Tree Wellness LLC
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• Leia Wolfe, RSST, CAC1
• Woodward Detroit CVS, L.L.C.
• Lauren Worth, DO
• Nancy Lynn Wucetich, LMSW, ACSW
• Silvana Xhajaj, FNP, BC
• Dennis Yager, SWT, CAC1
• Raegan Yerington

• Gastroenterology Physician in Berkley, MI
• Providers in Berkley, MI by specialty
• Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.