Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036-081437 | IL |
N | 207V00000X | Obstetrician & Gynecologist | 35120020 | WI |
Y | 207V00000X | Obstetrician & Gynecologist | MD60660936 | WA |
NPI | 1013925049 |
---|---|
Provider Name | David R Bhaskar |
First Address | Enumclaw, WA 98022-3504 |
Second Address | Enumclaw, WA 98022-3504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 01/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013925049 | (05) | WI |
10811 | DEAN HEALTH PLAN HMO (01) | |
2072284 | (05) | WA |
F23112 | (02) |