Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shivam Desai, MD

Individual provider Family Medicine Physician · NPI 1528591716

Shivam Desai, MD is a Family Practice in Douglasville, Georgia. Qualified in 2017, 9 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
9
Licensed in
GA
In the registry since
2017
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4904 Timber Ridge Dr Ste 102
Douglasville, GA 30135-1831
Phone: (678) 401-4597
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 83654 (GA)

Record details

NPI number1528591716
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 5, 2017
Last updated in NPPESMarch 25, 2023
Certification dateMarch 25, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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