Provider Demographics
NPI:1982835344
Name:BRAHMBHATT, RUSHIN D (MD)
Entity Type:Individual
Prefix:
First Name:RUSHIN
Middle Name:D
Last Name:BRAHMBHATT
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:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-247-2663
Mailing Address - Fax:515-643-8688
Practice Address - Street 1:411 LAUREL ST STE 2100
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3026
Practice Address - Country:US
Practice Address - Phone:515-247-2663
Practice Address - Fax:515-643-8688
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-45681208600000X, 2086X0206X
MN52944208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP00970211OtherRAILROAD MEDICARE
MNP00970211OtherRAILROAD MEDICARE