Provider Demographics
NPI:1699793596
Name:BHAN, BHAVIKA (MD)
Entity type:Individual
Prefix:DR
First Name:BHAVIKA
Middle Name:
Last Name:BHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:BHAVIKA
Other - Middle Name:
Other - Last Name:CHOWDHURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:901 E. 104TH ST.
Mailing Address - Street 2:MAILSTOP 400N
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-502-7104
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:12330 METCALF AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1324
Practice Address - Country:US
Practice Address - Phone:913-317-3170
Practice Address - Fax:913-317-3192
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003010382207R00000X
KS0432076207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG93000011Medicare PIN