Healthcare Provider Details

I. General information

NPI: 1164487567
Provider Name (Legal Business Name): BHARATI KHARKAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 COTA DR
BLOOMINGTON IN
47403-4211
US

IV. Provider business mailing address

PO BOX 4366
BLOOMINGTON IN
47402-4366
US

V. Phone/Fax

Practice location:
  • Phone: 812-332-8242
  • Fax: 812-333-7684
Mailing address:
  • Phone: 812-332-8242
  • Fax: 812-333-7684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number01030650A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: