MEDICARE: RAJVINDER BHATIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901020309	MI

General Provider Information

NPI Number	:	1053620476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJVINDER BHATIA

Provider Business Mailing Address
First Line	:	PO BOX 3189
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13220-3189
Country	:	US
Telephone Number	:	315-454-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 WILDER RD
Second Line	:	SUITE A
City	:	BAY CITY
State	:	MI
Zip	:	48706-2173
Country	:	US
Telephone Number	:	989-895-6600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2010
Last Update Date	:	10/04/2010

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Directions to “ RAJVINDER BHATIA ” Practice Location

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