Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 0101253479 | VA |
N | 2086S0129X | Vascular Surgeon | PENDING | AZ |
NPI | 1043535602 |
---|---|
Provider Name | Siddharth Kishore Bhende |
First Address | Virginia Beach, VA 23452-5765 |
Second Address | Virginia Beach, VA 23452-5765 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2010 |
Last Update Date | 26/07/2014 |