Provider Demographics
NPI:1699972265
Name:BHATT, NISHANT (MD)
Entity type:Individual
Prefix:DR
First Name:NISHANT
Middle Name:
Last Name:BHATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 13TH ST APT B5
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-1009
Mailing Address - Country:US
Mailing Address - Phone:315-794-0362
Mailing Address - Fax:
Practice Address - Street 1:4510 MEDICAL CENTER DR STE 202
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1605
Practice Address - Country:US
Practice Address - Phone:315-794-0362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002402207Y00000X
TXV11932086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA002402OtherRESIDENCY TRAINING PERMIT