Individual
DR. PRASHANT DATTATRAYA BHAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD DEPARTMENT OF INTERNAL MEDICINE, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
MEDICAL CENTER BLVD DEPARTMENT OF INTERNAL MEDICINE, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
41219
IA
207R00000X
Internal Medicine Physician
A97494
CA
207RC0000X
Cardiovascular Disease Physician
41219
IA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
41219
IA
Other
Enumeration date
02/28/2007
Last updated
05/20/2019
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