Provider Demographics
NPI:1184936890
Name:BHANOT, DEEPA (MD)
Entity type:Individual
Prefix:
First Name:DEEPA
Middle Name:
Last Name:BHANOT
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 1:1010 N. KANSAS
Mailing Address - Street 2:WCGME
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214
Mailing Address - Country:US
Mailing Address - Phone:316-268-5000
Mailing Address - Fax:
Practice Address - Street 1:100 RAWLINS DR
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5881
Practice Address - Country:US
Practice Address - Phone:302-990-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0011678207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease