Provider Demographics
NPI:1518923473
Name:BHANDARI, GUNJANA (MD)
Entity Type:Individual
Prefix:
First Name:GUNJANA
Middle Name:
Last Name:BHANDARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:BOX 42
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-8419
Mailing Address - Fax:269-341-8743
Practice Address - Street 1:300 NORTH AVE
Practice Address - Street 2:4TH FLOOR NURSING ADMINISTRATION
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3307
Practice Address - Country:US
Practice Address - Phone:269-245-5780
Practice Address - Fax:269-245-5781
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301085839207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1518923473Medicaid
MI1417961137OtherBCBSM - BRONSON BATTLE CREEK
I42453Medicare UPIN
P15870002Medicare ID - Type Unspecified
MI1518923473Medicaid