Provider Demographics
NPI:1538173109
Name:BHATIA, SUNIL K (MD)
Entity type:Individual
Prefix:
First Name:SUNIL
Middle Name:K
Last Name:BHATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8614
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:701 GROVE RD STE 200
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4210
Practice Address - Country:US
Practice Address - Phone:864-455-8988
Practice Address - Fax:864-455-8981
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2021-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC214382084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC301100Medicaid
SC214388Medicaid
NC5917279Medicaid
SCAA92667652OtherMEDICARE PIN
H12866Medicare UPIN
SCH128667652Medicare UPIN
NC5917279Medicaid