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General NPI Number Information
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NPI Number | 1124388947
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Entity Type | Individual
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Provider Name | HADI BHURGRI MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2012
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 100 HOSPITAL DR
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City | KETCHUM
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State | ID
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Zip | 83340
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Country | US
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Telephone | 208-727-8888
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Fax | 208-727-8889
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Provider Business Mailing Address
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Address Line | 1050 W 10TH ST
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City | ROLLA
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State | MO
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Zip | 65401-2905
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Country | US
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Telephone | 573-458-3581
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Fax | 573-202-2408
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 9371944
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 2016040197
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License Number State | MO
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