Provider Demographics
NPI:1467886341
Name:BHATTI GASTROENTEROLOGY CONSULTANTS, P.A.
Entity Type:Organization
Organization Name:BHATTI GASTROENTEROLOGY CONSULTANTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AHSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BHATTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-500-3271
Mailing Address - Street 1:1801 19TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-4946
Mailing Address - Country:US
Mailing Address - Phone:320-235-2020
Mailing Address - Fax:320-214-5761
Practice Address - Street 1:1457 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2525
Practice Address - Country:US
Practice Address - Phone:952-368-3800
Practice Address - Fax:952-368-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43105208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN754472300Medicaid
MN754472300Medicaid