Healthcare Provider Details

I. General information

NPI: 1770564973
Provider Name (Legal Business Name): RAMDAS BHANDARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 E NIZHONI BLVD
GALLUP NM
87301-1337
US

IV. Provider business mailing address

1234 S DIXIE HWY #406
CORAL GABLES FL
33146
US

V. Phone/Fax

Practice location:
  • Phone: 505-722-1000
  • Fax: 505-722-1256
Mailing address:
  • Phone: 305-720-4111
  • Fax: 305-669-4774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME0029458
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD20050463
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: