Individual
DR. MANIKA BHATEJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
18580 JOPLIN AVE, LAKEVILLE, MN 55044-4218
(952) 892-9555
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(776) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036-130722
IL
208000000X
Pediatrics Physician
4301094895
MI
208000000X
Pediatrics Physician
Primary
70561
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036130722
IL PHYSICIAN LICENSE
IL
05
—
036130722
—
IL
01
—
070
TRICARE
IL
Enumeration date
07/14/2009
Last updated
03/07/2023
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