Provider Demographics
NPI:1437598513
Name:BHUTANI, SUCHIT K (MD)
Entity Type:Individual
Prefix:
First Name:SUCHIT
Middle Name:K
Last Name:BHUTANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 S 11TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4824
Mailing Address - Country:US
Mailing Address - Phone:159-556-7662
Mailing Address - Fax:215-503-3408
Practice Address - Street 1:111 S 11TH ST FL 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:159-556-7662
Practice Address - Fax:215-503-3408
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD458466207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine