Provider Demographics
NPI:1437191103
Name:PANDYA, BHAVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BHAVIN
Middle Name:
Last Name:PANDYA
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 1:7905 CALUMET AVE
Mailing Address - Street 2:HAMMOND CLINIC LLC
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2549
Mailing Address - Country:US
Mailing Address - Phone:219-836-7214
Mailing Address - Fax:219-934-9815
Practice Address - Street 1:7905 CALUMET AVE
Practice Address - Street 2:HAMMOND CLINIC LLC
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2549
Practice Address - Country:US
Practice Address - Phone:219-836-7214
Practice Address - Fax:219-934-9815
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053563A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200446540AMedicaid
IN473060S2Medicare ID - Type Unspecified