# PROMIL BHUTANI

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1164581625
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 52748 | MN | Yes |
| 207Q00000X | Family Medicine Physician | MD2006-0509 | NM | — |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 11/26/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03073335 | — | NM |
| 05 | — | 1164581625 | — | MN |
| 01 | — | MD2006-0509 | LICENSE | NM |
| 01 | — | NM001P81 | BCBS | NM |
| 01 | — | P00405998 | RAILROAD MEDICARE | NM |