Healthcare Provider Details

I. General information

NPI: 1811567365
Provider Name (Legal Business Name): DEESHA RAJESH BHOJWANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 MISSION DR
JEFFERSON CITY MO
65109-9508
US

IV. Provider business mailing address

2505 MISSION DR
JEFFERSON CTY MO
65109-9508
US

V. Phone/Fax

Practice location:
  • Phone: 573-681-3000
  • Fax:
Mailing address:
  • Phone: 573-681-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2021023203
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2024022624
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: