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General NPI Number Information
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NPI Number | 1144464884
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Entity Type | Individual
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Provider Name | MR. BHARAT BHUSHAN
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Gender | Male
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Dates
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Enumeration Date | 04/24/2009
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Last Update Date | 01/21/2021
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Provider Practice Location Address
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Address Line | 602 INDIANA AVE
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City | LUBBOCK
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State | TX
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Zip | 79415-3364
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Country | US
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Telephone | 806-761-0878
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Fax |
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Provider Business Mailing Address
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Address Line | 2916 COLD SPRING WAY APT 374
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City | CROFTON
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State | MD
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Zip | 21114-2860
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Country | US
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Telephone | 630-974-8210
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD443139
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R6150
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD443139
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License Number State | PA
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