Provider Demographics
NPI:1134385941
Name:BHASKAR, HEMLATA (MD)
Entity type:Individual
Prefix:
First Name:HEMLATA
Middle Name:
Last Name:BHASKAR
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 1:781 LAKESHIRE TRAIL
Mailing Address - Street 2:P.O. BOX 747
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1561
Mailing Address - Country:US
Mailing Address - Phone:517-265-0600
Mailing Address - Fax:517-263-0024
Practice Address - Street 1:781 LAKESHIRE TRAIL
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1561
Practice Address - Country:US
Practice Address - Phone:517-263-2187
Practice Address - Fax:517-263-0024
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100055207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM35150083Medicare PIN