MEDICARE: DAVINDER BHULLAR 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
1	207R00000X	Internal Medicine Physician	35.096206	OH

General Provider Information

NPI Number	:	1649573684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVINDER BHULLAR MD

Provider Business Mailing Address
First Line	:	PO BOX 26070
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44319-6070
Country	:	US
Telephone Number	:	330-564-2661
Fax Number	:	330-493-7123

Provider Business Practice Location Address
First Line	:	13916 CEDAR RD
Second Line	:
City	:	UNIVERSITY HTS
State	:	OH
Zip	:	44118-3204
Country	:	US
Telephone Number	:	216-397-9000
Fax Number	:	216-397-9005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2010
Last Update Date	:	12/14/2010

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Directions to “ DAVINDER BHULLAR MD” Practice Location

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