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Individual

JAYSHREE S BHATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD PC

Contact information

Practice address
9124 COLUMBIA AVE, SUITE B, MUNSTER, IN 46321
(219) 836-0445
(219) 836-0463
Mailing address
9124 COLUMBIA AVE, SUITE B, MUNSTER, IN 46321-2907
(219) 836-0445
(219) 836-0463

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01033072
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1396942124
MEDICARE RAILROAD
IN
01
1831106186
INDIVIDUAL NPI
IN
01
703100
MEDICARE
IN
01
P00731929
MEDICARE RAILROAD
IN
Enumeration date
08/01/2006
Last updated
07/03/2018
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