Provider Demographics
NPI:1417246877
Name:BHANDARI, SHIV RAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIV
Middle Name:RAJ
Last Name:BHANDARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 N CIVIC CENTER PLZ
Mailing Address - Street 2:UNIT 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7901
Mailing Address - Country:US
Mailing Address - Phone:602-579-3832
Mailing Address - Fax:
Practice Address - Street 1:3031 N CIVIC CENTER PLZ
Practice Address - Street 2:UNIT 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7901
Practice Address - Country:US
Practice Address - Phone:602-579-3832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS23430208M00000X
AZ50908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist