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1669458857

NPI Code Detail

MEDICARE: MANDEEP S BAKSHI MD

MEDICARE: MANDEEP S BAKSHI 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	38797	TN
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	38797	TN
3	208M00000X	Hospitalist Physician	MD38797	TN
4	207RP1001X	Pulmonary Disease Physician	MD38797	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4330458	OTHER	TN	BCBS OF TN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669458857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANDEEP S BAKSHI MD

Provider Business Mailing Address
First Line	:	1404 TUSCULUM BLVD 2200
Second Line	:
City	:	GREENEVILLE
State	:	TN
Zip	:	37745-4395
Country	:	US
Telephone Number	:	423-798-8052
Fax Number	:	423-798-8055

Provider Business Practice Location Address
First Line	:	401 TAKOMA AVE
Second Line	:
City	:	GREENEVILLE
State	:	TN
Zip	:	37743-4647
Country	:	US
Telephone Number	:	423-278-1743
Fax Number	:	423-278-1930

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	04/08/2025

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Directions to “ MANDEEP S BAKSHI MD” Practice Location

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