Healthcare Provider Details

I. General information

NPI: 1811200744
Provider Name (Legal Business Name): ADNAN MUSTAFA BHOPALWALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2010
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 HOSPITAL RD
WHITESBURG KY
41858-7627
US

IV. Provider business mailing address

214 HOSPITAL RD STE B
WHITESBURG KY
41858-7627
US

V. Phone/Fax

Practice location:
  • Phone: 606-633-6239
  • Fax:
Mailing address:
  • Phone: 606-633-4414
  • Fax: 606-633-6205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD17071
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number48700
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301096876
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: