# DEVINDERJIT S BHANGU, MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225204399
- **Authorized official:** DR. DEVINDERJIT S BHANGU MD (OWNER)
- **Authorized official phone:** (810) 606-7152

## Contact information

- **Practice address:** 3605 GENESYS PKWY, GRAND BLANC, MI 48439-8070
- **Practice address phone:** (810) 606-7152
- **Practice address fax:** (810) 606-7155
- **Mailing address:** PO BOX 835, TROY, MI 48099-0835
- **Mailing address phone:** (248) 346-3062
- **Mailing address fax:** (810) 606-7155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4301071280 | MI | Yes |

## Other

- **Enumeration date:** 05/07/2008
- **Last updated:** 04/28/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0250410 | BLUE CARE NETWORK OF MICHIGAN | MI |
| 01 | — | 0983359 | HEALTH PLUS OF MICHIGAN | MI |
| 05 | — | 3498834 | — | MI |