M S Bhagavan M.D.

NPI 1174512917 - Internal Medicine - 207R00000X

NPI Details
NPI 1174512917
Gender Male
Enumeration Date 10/14/2005
Last Updated 06/23/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
1501 S CALIFORNIA AVE
CHICAGO IL, 60608-1732, US
Phone (708) 275-7458
Fax
Business Location
645 S CENTRAL AVE
CHICAGO IL, 60644-5059, US
Phone (708) 275-7458
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Illinois
License Number 036-094099
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According to our database, Dr. M S Bhagavan M.D. NPI is 1174512917, taxonomy code is 207R00000X and license number is 036-094099, license state is located at Illinois. M S Bhagavan M.D. physically located at 1501 S California Ave, Chicago IL, 60608-1732. NPI Number M S Bhagavan M.D. has the Individual type.

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1174512917 NPI number is provided on an as is basis without warranty of any kind. 1174512917 is maintained by the National Plan & Provider Enumeration System. The contents of M S Bhagavan M.D. are for informational purposes only.