Provider Demographics
NPI:1972348803
Name:BHUTTA, BEENISH SOHAIL (MD)
Entity type:Individual
Prefix:DR
First Name:BEENISH
Middle Name:SOHAIL
Last Name:BHUTTA
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3440 N. BOARD STREET DEPARTMENT OF NEPHROLOGY
Mailing Address - Street 2:KRESGE BUILDING, STE 100 WEST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140
Mailing Address - Country:US
Mailing Address - Phone:215-707-7937
Mailing Address - Fax:215-707-9697
Practice Address - Street 1:3440 N. BOARD STREET DEPARTMENT OF NEPHROLOGY
Practice Address - Street 2:KRESGE BUILDING, STE 100 WEST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140
Practice Address - Country:US
Practice Address - Phone:215-707-7937
Practice Address - Fax:215-707-9697
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT231924390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program