Provider Demographics
NPI:1083970123
Name:BHANDARI, SAHITYA (MD)
Entity Type:Individual
Prefix:
First Name:SAHITYA
Middle Name:
Last Name:BHANDARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 JEFFERSON DAVIS BLVD
Mailing Address - Street 2:STE 130
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5107
Mailing Address - Country:US
Mailing Address - Phone:601-304-2901
Mailing Address - Fax:601-446-9834
Practice Address - Street 1:150 JEFFERSON DAVIS BLVD
Practice Address - Street 2:STE 130
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-5107
Practice Address - Country:US
Practice Address - Phone:601-304-2901
Practice Address - Fax:601-446-9834
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MS24034207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program