MEDICARE: BHATTI GI SURGERY CENTER LLC

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	261QA1903X	Ambulatory Surgical Clinic/Center	2039	MN

General Provider Information

NPI Number	:	1265959795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHATTI GI SURGERY CENTER LLC

Provider Business Mailing Address
First Line	:	1447 WHITE OAK DR
Second Line	:
City	:	CHASKA
State	:	MN
Zip	:	55318-2525
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1447 WHITE OAK DR
Second Line	:
City	:	CHASKA
State	:	MN
Zip	:	55318
Country	:	US
Telephone Number	:	952-368-3800
Fax Number	:

Authorized Official
Title or Position	:	M.D.
Name	:	AHSAN BHATTI
Credential	:
Telephone Number	:	952-368-3800

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	01/20/2020

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