Provider Demographics
NPI:1700179348
Name:BHAKTA, DHARMESH G (RPH)
Entity type:Individual
Prefix:
First Name:DHARMESH
Middle Name:G
Last Name:BHAKTA
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 1:8620 CAMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2396
Mailing Address - Country:US
Mailing Address - Phone:704-542-1584
Mailing Address - Fax:704-341-3831
Practice Address - Street 1:8620 CAMFIELD ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2396
Practice Address - Country:US
Practice Address - Phone:704-542-1584
Practice Address - Fax:704-341-3831
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12530183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist