Provider Demographics
NPI:1598752008
Name:BHAT, SHEELA B (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEELA
Middle Name:B
Last Name:BHAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHEELA
Other - Middle Name:B
Other - Last Name:PRASAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1619 N SWAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4046
Mailing Address - Country:US
Mailing Address - Phone:520-290-9151
Mailing Address - Fax:520-290-9152
Practice Address - Street 1:1619 N SWAN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4046
Practice Address - Country:US
Practice Address - Phone:520-290-9151
Practice Address - Fax:520-290-9152
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31113207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ756934Medicaid
AZ756934Medicaid
AZ109181Medicare PIN