Provider Demographics
NPI:1295708980
Name:NAYAK, BHADRESH DHIRUBHAI (MD)
Entity type:Individual
Prefix:MR
First Name:BHADRESH
Middle Name:DHIRUBHAI
Last Name:NAYAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BHADRESH
Other - Middle Name:DHIRUBHAI
Other - Last Name:NAYAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:43243 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1957
Mailing Address - Country:US
Mailing Address - Phone:586-268-3100
Mailing Address - Fax:586-268-0058
Practice Address - Street 1:43243 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1957
Practice Address - Country:US
Practice Address - Phone:586-268-3100
Practice Address - Fax:586-268-0058
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-11
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301058004207RH0003X
GA050484207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110500378OtherBCBS
MI412215510Medicaid
MI110500378OtherBCBS
MI412215510Medicaid