| Bhasker Medical Clinic Pc | |
|
200 Neel Ave Socorro NM 87801-4649 | |
| (575) 835-2940 | |
| (575) 835-2216 |
| Full Name | Bhasker Medical Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 200 Neel Ave, Socorro, New Mexico |
| Authorized Official Name and Position | Addy Bhasker (ADMINISTRATOR) |
| Authorized Official Contact | 5758352940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhasker Medical Clinic Pc 200 Neel Ave Socorro NM 87801-4649 Ph: (575) 835-2940 | Bhasker Medical Clinic Pc 200 Neel Ave Socorro NM 87801-4649 Ph: (575) 835-2940 |
| NPI Number | 1821189101 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 09/09/2015 |
| Medicare PECOS PAC ID | 0547174567 |
|---|---|
| Medicare Enrollment ID | O20031114000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821189101 | NPI | - | NPPES |
| 44073 | Medicaid | NM | |
| 201051377 | Other | NM | PREJB |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Ravi Bhasker |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326146259 PECOS PAC ID: 1355255373 Enrollment ID: I20100830001102 |
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