Provider Demographics
NPI:1124408240
Name:THANDI, BHUPINDER SINGH
Entity Type:Individual
Prefix:MR
First Name:BHUPINDER
Middle Name:SINGH
Last Name:THANDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7608 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-2822
Mailing Address - Country:US
Mailing Address - Phone:313-925-8000
Mailing Address - Fax:313-925-8008
Practice Address - Street 1:7608 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-2822
Practice Address - Country:US
Practice Address - Phone:313-925-8000
Practice Address - Fax:313-925-8008
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI471545862OtherIRS