Provider Demographics
NPI:1821120221
Name:BHATT, SMITA B (MD)
Entity Type:Individual
Prefix:MRS
First Name:SMITA
Middle Name:B
Last Name:BHATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SMITA
Other - Middle Name:KEDARNATH
Other - Last Name:JOSHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5533 SHORE DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LK
Mailing Address - State:MI
Mailing Address - Zip Code:48324
Mailing Address - Country:US
Mailing Address - Phone:268-681-8170
Mailing Address - Fax:
Practice Address - Street 1:32355 CAPITOL
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150
Practice Address - Country:US
Practice Address - Phone:800-473-9702
Practice Address - Fax:734-524-9316
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI34346207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8634002Medicare ID - Type Unspecified
E87916Medicare UPIN