Provider Demographics
NPI:1285193409
Name:SWAMY, BHANU L (MD)
Entity type:Individual
Prefix:
First Name:BHANU
Middle Name:L
Last Name:SWAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2300 HAGGERTY RD STE 2150
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2192
Mailing Address - Country:US
Mailing Address - Phone:248-926-6610
Mailing Address - Fax:248-926-6611
Practice Address - Street 1:2300 HAGGERTY RD STE 2150
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2192
Practice Address - Country:US
Practice Address - Phone:248-926-6610
Practice Address - Fax:248-926-6611
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301507234207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine