Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301107989 | MI |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 11741853-1205 | UT |
NPI | 1790165447 |
---|---|
Provider Name | Neil Bakshi |
First Address | Salt Lake City, UT 84108-1200 |
Second Address | Salt Lake City, UT 84108-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 02/06/2020 |