Provider Demographics
NPI:1538102231
Name:BHATEJA, SUNAINA (MD)
Entity type:Individual
Prefix:
First Name:SUNAINA
Middle Name:
Last Name:BHATEJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ST MARYS EPWORTH XING # A200
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-9497
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 ST MARYS EPWORTH CROSSING
Practice Address - Street 2:STE A200
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-9695
Practice Address - Country:US
Practice Address - Phone:812-485-5040
Practice Address - Fax:812-228-5304
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051133207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200243210Medicaid
IN200243210Medicaid
IN000000336526OtherBCBS PROVIDER #
IN940280E7Medicare ID - Type Unspecified