Individual
DR. PAVAN KUMAR BHAMIDIPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303
(302) 229-4907
(302) 229-5160
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(302) 229-4907
(302) 229-5160
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2012019678
MO
207RH0003X
Hematology & Oncology Physician
63587
MN
208M00000X
Hospitalist Physician
2012019678
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IL
Enumeration date
07/21/2009
Last updated
04/25/2025
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