MEDICARE: DR. ABDHISH RAMAN BHAVSAR M.D.

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	207WX0107X	Retina Specialist (Ophthalmology) Physician	036096763	IL
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	G81049	CA
3	207WX0107X	Retina Specialist (Ophthalmology) Physician	39922	MN

General Provider Information

NPI Number	:	1396776951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDHISH RAMAN BHAVSAR M.D.

Provider Business Mailing Address
First Line	:	710 E 24TH ST
Second Line	:	SUITE 304
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3846
Country	:	US
Telephone Number	:	612-871-2292
Fax Number	:	952-460-5274

Provider Business Practice Location Address
First Line	:	710 E 24TH ST STE 304
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3846
Country	:	US
Telephone Number	:	612-871-2292
Fax Number	:	952-460-5274

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	09/29/2020

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