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NPI Code Detail

MEDICARE: DISHANG RAJENDRAKUMAR BHAVSAR MD

MEDICARE: DISHANG RAJENDRAKUMAR BHAVSAR MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician2023048812MO

General Provider Information

NPI Number : 1528588670
Entity Type Code : Individual
Provider Name (Legal Business Name) : DISHANG RAJENDRAKUMAR BHAVSAR MD
Provider Business Mailing Address
First Line : 121 DEKALB AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5425
Country : US
Telephone Number : 718-250-6604
Fax Number :
Provider Business Practice Location Address
First Line : 1500 N OAKLAND AVE
Second Line :
City : BOLIVAR
State : MO
Zip : 65613-3011
Country : US
Telephone Number : 417-328-7930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2017
Last Update Date : 02/25/2026

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