Provider Demographics
NPI:1447221478
Name:BHASIN, PRAMIT (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAMIT
Middle Name:
Last Name:BHASIN
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 1:300 S 8TH ST STE 480W
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2403
Mailing Address - Country:US
Mailing Address - Phone:270-762-1792
Mailing Address - Fax:270-762-1783
Practice Address - Street 1:300 S 8TH ST STE 301E
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2403
Practice Address - Country:US
Practice Address - Phone:270-762-1566
Practice Address - Fax:270-752-2858
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350890142084N0400X
IA429472084N0400X
KY376442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64058043Medicaid
OH2366023Medicaid
OH2366023Medicaid