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General NPI Number Information
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NPI Number | 1629567425
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Entity Type | Individual
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Provider Name | AYUSH BHAKTA SHRESTHA MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 254 E 127TH PL
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City | CROWN POINT
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State | IN
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Zip | 46307-7560
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Country | US
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Telephone | 859-285-1065
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Fax |
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Provider Business Mailing Address
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Address Line | 254 E 127TH PL
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City | CROWN POINT
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State | IN
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Zip | 46307-7560
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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 | 4351044243
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 71515
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License Number State | TN
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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 | 2023024272
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 71515
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01097985A
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License Number State | IN
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