Provider Demographics
NPI:1457425670
Name:BHESANIA, ZUBIN (MD)
Entity Type:Individual
Prefix:
First Name:ZUBIN
Middle Name:
Last Name:BHESANIA
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 1:1522 PINE GROVE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3382
Mailing Address - Country:US
Mailing Address - Phone:810-987-3556
Mailing Address - Fax:810-987-5090
Practice Address - Street 1:1522 PINE GROVE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3382
Practice Address - Country:US
Practice Address - Phone:810-987-3556
Practice Address - Fax:810-987-5090
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301063455208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0740158OtherBCBS
MI0003435OtherCHAMPUS TRICARE
G99394OtherHAP
7365010OtherAETNA
126890OtherCARE CHOICE
MI0740158OtherBCBS
126890OtherCARE CHOICE