Provider Demographics
NPI:1417079450
Name:BHULLAR, SIMRIT K (DO)
Entity Type:Individual
Prefix:
First Name:SIMRIT
Middle Name:K
Last Name:BHULLAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 OLENTANGY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3908
Mailing Address - Country:US
Mailing Address - Phone:614-442-2406
Mailing Address - Fax:614-442-2410
Practice Address - Street 1:3535 OLENTANGY RIVER RD
Practice Address - Street 2:RMH 4 TOWER ICU
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-566-4691
Practice Address - Fax:614-566-6854
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008508207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000518804OtherANTHEM
OH2749753Medicaid
OHP00401751OtherRR- MCR
OHP00401751OtherRR- MCR