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NPI Code Detail

MEDICARE: DR. PRAMEET JAGDISH BHUSHAN M.D.

MEDICARE: DR. PRAMEET JAGDISH BHUSHAN 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
12084F0202XForensic Psychiatry Physician42130TN
22084F0202XForensic Psychiatry Physician057776GA
32084P0800XPsychiatry Physician42130TN

General Provider Information

NPI Number : 1508084864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRAMEET JAGDISH BHUSHAN M.D.
Provider Business Mailing Address
First Line : 6401 SHALLOWFORD RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-5406
Country : US
Telephone Number : 423-899-6500
Fax Number : 423-899-5688
Provider Business Practice Location Address
First Line : 6401 SHALLOWFORD RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-5406
Country : US
Telephone Number : 423-893-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 09/07/2023

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