Provider Demographics
NPI:1649573684
Name:BHULLAR, DAVINDER (MD)
Entity Type:Individual
Prefix:
First Name:DAVINDER
Middle Name:
Last Name:BHULLAR
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:PO BOX 26070
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-6070
Mailing Address - Country:US
Mailing Address - Phone:330-564-2661
Mailing Address - Fax:330-493-7123
Practice Address - Street 1:13916 CEDAR RD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-3204
Practice Address - Country:US
Practice Address - Phone:216-397-9000
Practice Address - Fax:216-397-9005
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.096206207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine