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NPI Code Detail

MEDICARE: KRISHNA PRASAD BHETWAL

MEDICARE: KRISHNA PRASAD BHETWAL
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
1175T00000XPeer Specialist
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1508585811
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISHNA PRASAD BHETWAL
Provider Business Mailing Address
First Line : 7220 28TH ST S
Second Line :
City : FARGO
State : ND
Zip : 58104-4589
Country : US
Telephone Number : 701-630-9912
Fax Number :
Provider Business Practice Location Address
First Line : 7220 28TH ST S
Second Line :
City : FARGO
State : ND
Zip : 58104-4589
Country : US
Telephone Number : 701-630-9912
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2022
Last Update Date : 01/16/2023

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Directions to “ KRISHNA PRASAD BHETWAL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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