Individual
MANAVENDRA BAKHSHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 E LEHIGH AVE # MAB-204, PHILADELPHIA, PA 19125-1012
(215) 707-1136
(215) 707-1142
Mailing address
PO BOX 820933, PHILADELPHIA, PA 19182-0933
(215) 707-1136
(215) 707-1142
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD052164L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001604820
—
PA
01
—
01604820-07
AMERICHOICE
PA
01
—
0803108000
INDEPENDENCE BLUE CROSS
PA
01
—
1072701
KEYSTONE MERCY HEALTH PLA
PA
01
—
2653
BRAVO HEALTH
PA
01
—
3207161
AETNA HMO
PA
01
—
3Y5968
HEALTH NET
PA
01
—
451504
COVENTRY HEALTH AMERICA
PA
01
—
5959583
AETNA PPO
PA
01
—
597586
MEDICARE GROUP TPI
PA
01
—
778197
HIGHMARK BLUE SHIELD
PA
01
—
CD4829
RAILROAD MEDICARE GROUP TPI
PA
01
—
P00022197
RAILROAD MEDICARE
PA
Enumeration date
12/01/2005
Last updated
05/20/2019
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