Individual
DR. KRISHNA BHATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 WESTERN AVE, MANITOWOC, WI 54220-3712
(920) 320-3880
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2591
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
24465
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2084P0800X
—
WI
01
—
24465
LICENSE
WI
01
—
P00736811
RR MEDICARE
WI
Enumeration date
05/28/2006
Last updated
07/09/2012
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