Individual
HIMABINDU BANDARU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 E 3900 S, SUITE 4B, SALT LAKE CITY, UT 84124-1300
(866) 500-7071
(866) 500-7081
Mailing address
3350 S 2940 E, PO BOX 9677, SALT LAKE CITY, UT 84109-3159
(866) 500-7071
(866) 500-7081
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101243676
VA
207R00000X
Internal Medicine Physician
4301086019
MI
207R00000X
Internal Medicine Physician
N8272
TX
208M00000X
Hospitalist Physician
0101243676
VA
208M00000X
Hospitalist Physician
Primary
9065324-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G56008
BCBSM GROUP PIN
MI
01
—
1107510812
BCBSM PIN
MI
05
—
1750583746
—
MI
05
—
7100049880
—
KY
Enumeration date
06/03/2007
Last updated
07/07/2014
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