Provider Demographics
NPI:1952302911
Name:BHASIN, SUNITA M (MD)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:M
Last Name:BHASIN
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 1748
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-5748
Mailing Address - Country:US
Mailing Address - Phone:306-325-7460
Mailing Address - Fax:304-323-2575
Practice Address - Street 1:1609 STADIUM DR
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-3321
Practice Address - Country:US
Practice Address - Phone:304-325-7460
Practice Address - Fax:304-323-2575
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16568207R00000X
VA0101222136207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine