Devanagondi, Bhaskar

Devanagondi, Bhaskar is an individual health care provider with primary practice located at 2110 16Th St 1 Bay Pediatric Clinic, Bay MI 48708. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Devanagondi, Bhaskar can be contacted via phone (989) 892-2517.

Contact Information

Primary practice address
2110 16Th St 1 Bay Pediatric Clinic Bay MI 48708
Phone: (989) 892-2517
Fax: (989) 892-4860
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X BD049357 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X BD049357 Michigan

Profile Details

NPI number 1386704419
LBN Legal business name Devanagondi, Bhaskar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2006
Last updated Aug 23rd, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386704419 NPPES
Michigan Other 350Z96028 BLUE CROSS
Michigan Other 3500941021 BLUE CROSS
Michigan MEDICAID 1821116 BLUE CROSS

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