Provider Demographics
NPI:1295153906
Name:BHATTI, MONA (MD)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:BHATTI
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 1:6716 NOLENSVILLE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8865
Mailing Address - Country:US
Mailing Address - Phone:615-941-7501
Mailing Address - Fax:615-941-7502
Practice Address - Street 1:6716 NOLENSVILLE RD STE 210
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8865
Practice Address - Country:US
Practice Address - Phone:615-941-7501
Practice Address - Fax:615-941-7502
Is Sole Proprietor?:No
Enumeration Date:2014-03-31
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146970207Q00000X
MI4301104942207Q00000X
VA0101273845207Q00000X
TN71265207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110447500Medicaid