Individual
DR. DICKY GIRISH BHAGAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2240 KARISA DR, SUITE 1, GOSHEN, IN 46526-6943
(574) 534-6757
(574) 537-0357
Mailing address
2240 KARISA DR, SUITE 1, GOSHEN, IN 46526-6943
(574) 534-6757
(574) 537-0357
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01054743A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000322073
ANTHEM PROVIDER NO.
IN
05
—
200323890A
—
IN
Enumeration date
05/23/2005
Last updated
02/22/2024
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