Provider Demographics
NPI:1699973552
Name:DEOL, BHUVNEESH SINGH (RPH)
Entity type:Individual
Prefix:
First Name:BHUVNEESH
Middle Name:SINGH
Last Name:DEOL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 HARTLAND DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-5453
Mailing Address - Country:US
Mailing Address - Phone:248-743-1550
Mailing Address - Fax:
Practice Address - Street 1:1303 HARTLAND DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-5453
Practice Address - Country:US
Practice Address - Phone:248-743-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302033591OtherPHARMACIST