Provider Demographics
NPI:1689052623
Name:BHULABHAI, BHAVIK KIRAN (MD)
Entity Type:Individual
Prefix:
First Name:BHAVIK
Middle Name:KIRAN
Last Name:BHULABHAI
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 1:789 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2526
Mailing Address - Country:US
Mailing Address - Phone:603-664-2135
Mailing Address - Fax:
Practice Address - Street 1:8 CENTURY PINES DR STE 2
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825
Practice Address - Country:US
Practice Address - Phone:603-664-2135
Practice Address - Fax:603-664-9128
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH18648207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3111907Medicaid