Provider Demographics
NPI:1760007827
Name:ADHIKARI, BHIM RAJ
Entity type:Individual
Prefix:MR
First Name:BHIM
Middle Name:RAJ
Last Name:ADHIKARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 WAGENER PL
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-6962
Mailing Address - Country:US
Mailing Address - Phone:612-636-2983
Mailing Address - Fax:651-493-7539
Practice Address - Street 1:1901 WAGENER PL
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-6962
Practice Address - Country:US
Practice Address - Phone:612-636-2983
Practice Address - Fax:651-493-7539
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-14
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1100439253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN80-0885962Medicaid