Provider Demographics
NPI:1801955232
Name:BHIRUD, NILIMA RAVINDRANATH (M D)
Entity type:Individual
Prefix:
First Name:NILIMA
Middle Name:RAVINDRANATH
Last Name:BHIRUD
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 MOUNTAIN VISTA LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-9627
Mailing Address - Country:US
Mailing Address - Phone:304-421-3892
Mailing Address - Fax:
Practice Address - Street 1:845 MOUNTAIN VISTA LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-9627
Practice Address - Country:US
Practice Address - Phone:304-421-3892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.141977207R00000X
NC2017-02612207R00000X
WV13751207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0084149000Medicaid
WV8804515Medicare PIN
WV0084149000Medicaid