Healthcare Provider Details

I. General information

NPI: 1699793596
Provider Name (Legal Business Name): BHAVIKA BHAN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BHAVIKA CHOWDHURY MBBS

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12330 METCALF AVE SUITE 500
OVERLAND PARK KS
66213-1324
US

IV. Provider business mailing address

901 E. 104TH ST. MAILSTOP 400N
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 913-317-3170
  • Fax: 913-317-3192
Mailing address:
  • Phone: 816-502-7104
  • Fax: 816-932-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2003010382
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number0432076
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: