Provider Demographics
NPI:1457329898
Name:BHANDARKAR, GEETHA M (MD)
Entity Type:Individual
Prefix:
First Name:GEETHA
Middle Name:M
Last Name:BHANDARKAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:26901 BEAUMONT BLVD
Mailing Address - Street 2:STE 3D
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1863
Mailing Address - Fax:941-522-0307
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:OAKWOOD HOSPITAL MEDICAL CENTER
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-593-7965
Practice Address - Fax:313-593-7143
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2019-01-22
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Provider Licenses
StateLicense IDTaxonomies
MI059995207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4417447Medicaid
MI220032351OtherRR MCR