Individual
NISHA L BHATIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13460 N 94TH DR STE J1, PEORIA, AZ 85381-4246
(623) 876-8816
(623) 298-0168
Mailing address
13460 N 94TH DR STE J1, PEORIA, AZ 85381-4246
(623) 876-8816
(623) 298-0168
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34896
AZ
207RC0000X
Cardiovascular Disease Physician
Primary
34896
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221915
—
AZ
01
—
P00624339
RAILROAD MEDICARE
AZ
01
—
Z208887
MEDICARE
AZ
Enumeration date
03/14/2006
Last updated
05/15/2019
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