Provider Demographics
NPI:1730160383
Name:BHARGAVA, VASHALI (MD)
Entity type:Individual
Prefix:DR
First Name:VASHALI
Middle Name:
Last Name:BHARGAVA
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 1:15500 LUNDY PKWY
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2778
Mailing Address - Country:US
Mailing Address - Phone:313-586-4906
Mailing Address - Fax:313-792-7134
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:OHMC, DEPARTMENT OF OB/GYN, LABOR AND DELIVERY
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-593-7500
Practice Address - Fax:313-593-8840
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301075959207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F36482010Medicare ID - Type Unspecified