Provider Demographics
NPI:1407836547
Name:GANDHI, LINUS BHUPENDRA (M D)
Entity type:Individual
Prefix:DR
First Name:LINUS
Middle Name:BHUPENDRA
Last Name:GANDHI
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 HIGHWAY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-1615
Mailing Address - Country:US
Mailing Address - Phone:219-838-9333
Mailing Address - Fax:
Practice Address - Street 1:2727 HIGHWAY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-1615
Practice Address - Country:US
Practice Address - Phone:219-838-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057594A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200462470Medicaid
IN212670BMedicare ID - Type Unspecified
INH96989Medicare UPIN