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Individual
MRS. VIMLA PRAVENI BHAGWANDIN
Active
Individual
MRS. VIMLA PRAVENI BHAGWANDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28261
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510I37000
MEDICARE PECOS
AL
01
—
515-45281
BLUE CROSS AND BLUE SHIELD OF ALABAMA
—
05
—
631500075
—
AL
Enumeration date
11/06/2007
Last updated
10/06/2018
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