Doctor Name: | DR. AMIT ISHWAR BHAVAN |
NPI Number: | 1104168269 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 62680-20 |
Business Practice Address: | 8701 W Watertown Plank Rd Department Of Psychiatry & Behavioral Medicine Milwaukee, WI - 532263548 |
Business Phone Number: | 4149558998 |
Business Fax Number: | 4149556299 |
Mailing Address: | 8701 W Watertown Plank Rd, Department Of Psychiatry & Behavioral Medicine MILWAUKEE |
State: | WI |
Postal Code: | 532263548 |
Phone Number: | 4149558998 |
Fax Number: | 4149556299 |
NPI Enumeration Date: | 03/26/2013 |
NPI Last Update Date: | 09/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 62680-20 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |