Provider Demographics
NPI: | 1982838744 |
---|---|
Name: | BHAYANI, PARIN M (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | PARIN |
Middle Name: | M |
Last Name: | BHAYANI |
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: | 5901 TECHNOLOGY CENTER DR |
Mailing Address - Street 2: | SUITE 130 |
Mailing Address - City: | INDIANAPOLIS |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 46278-6013 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 317-328-5050 |
Mailing Address - Fax: | 317-328-5053 |
Practice Address - Street 1: | 1704 N CAPITOL AVE |
Practice Address - Street 2: | B335 |
Practice Address - City: | INDIANAPOLIS |
Practice Address - State: | IN |
Practice Address - Zip Code: | 46202-3297 |
Practice Address - Country: | US |
Practice Address - Phone: | 317-962-8881 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-05-08 |
Last Update Date: | 2016-10-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
390200000X | ||
IN | 01073826A | 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IN | 959090019 | Medicare PIN | |
IN | P01406855 | Medicare PIN |