Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301090355 | MI |
N | 111NI0900X | Internist | 4301090355 | MI |
N | 207RN0300X | Nephrologist | 2013032860 | MO |
N | 207RN0300X | Nephrologist | 35.098709 | OH |
Y | 207RN0300X | Nephrologist | 65972 | WI |
NPI | 1053503607 |
---|---|
Provider Name | Dr. Samrat V Bhat |
First Address | Eau Claire, WI 54702-1510 |
Second Address | La Crosse, WI 54601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2007 |
Last Update Date | 16/09/2020 |