Individual
DR. BHASKAR PURUSHOTTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4150 5TH ST, RAPID CITY, SD 57701-6022
(605) 755-4300
(605) 755-1027
Mailing address
353 FAIRMONT BLVD, ATTN MSS, RAPID CITY, SD 57701-7350
(267) 516-5143
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9505
SD
390200000X
Student in an Organized Health Care Education/Training Program
MT189705
PA
Other
Enumeration date
07/19/2007
Last updated
08/18/2015
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