Provider Demographics
NPI:1700045366
Name:BAHL, REECHA SACHDEVA (MD)
Entity Type:Individual
Prefix:DR
First Name:REECHA
Middle Name:SACHDEVA
Last Name:BAHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1560 E. MAPLE RD.
Mailing Address - Street 2:SUITE 400 - CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1135
Mailing Address - Country:US
Mailing Address - Phone:313-577-8900
Mailing Address - Fax:313-577-0700
Practice Address - Street 1:4717 SAINT ANTOINE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-1423
Practice Address - Country:US
Practice Address - Phone:313-577-8900
Practice Address - Fax:313-577-0700
Is Sole Proprietor?:No
Enumeration Date:2008-06-08
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301097896207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P30630802Medicare PIN