Provider Demographics
NPI:1346030640
Name:BHARDWAJ, DIVYASHISH (MBBS)
Entity type:Individual
Prefix:
First Name:DIVYASHISH
Middle Name:
Last Name:BHARDWAJ
Suffix:
Gender:
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 JACKSON STREET PO BOX 1901 ST.FRANCIS MEDICAL CENTE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-1901
Mailing Address - Country:US
Mailing Address - Phone:318-966-7172
Mailing Address - Fax:318-966-8788
Practice Address - Street 1:309 JACKSON STREET PO BOX 1901 ST.FRANCIS MEDICAL CENTE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-1901
Practice Address - Country:US
Practice Address - Phone:318-966-7172
Practice Address - Fax:318-966-8788
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program