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General NPI Number Information
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NPI Number | 1356667273
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Entity Type | Individual
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Provider Name | SHIKHA BHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 1034 N 500 W
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City | PROVO
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State | UT
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Zip | 84604-3380
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Country | US
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Telephone | 405-323-8843
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Fax |
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Provider Business Mailing Address
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Address Line | 724 CAMI NICOLE LN
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City | SALT LAKE CITY
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State | UT
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Zip | 84107-3361
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-133164
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12383446-1205
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License Number State | UT
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