Provider Demographics
NPI:1568036358
Name:BHATTARAI, SHASHANK (MD)
Entity Type:Individual
Prefix:
First Name:SHASHANK
Middle Name:
Last Name:BHATTARAI
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:GME, 1 GUTHRIE SQ, INTERNAL MEDICINE
Mailing Address - Street 2:ROBERT PACKER HOSPITAL
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840
Mailing Address - Country:US
Mailing Address - Phone:570-887-4559
Mailing Address - Fax:
Practice Address - Street 1:ONE GUTHRIE SQUARE
Practice Address - Street 2:GUTHRIE ROBERT PACKER HOSPITAL
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840
Practice Address - Country:US
Practice Address - Phone:570-887-4559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMT223389390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program