Individual
DR. PRADEEP SRINIVAS BHANDARKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 19401 HUBBARD DRIVE, SUITE#202, DEARBORN, MI 48126
(313) 982-8419
(313) 982-4430
Mailing address
HENRY FORD HEALTH SYSTEM, 19401 HUBBARD DRIVE,SUITE #107, DEARBORN, MI 48126
(313) 982-8419
(313) 982-4430
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301058379
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307003610
—
MI
01
—
700H262310
BLUE CROSS-BLUE CROSS
—
01
—
MB058379
CHAMPUS-CHAMPUS
—
Enumeration date
12/18/2006
Last updated
04/02/2021
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