Provider Demographics
NPI:1679621916
Name:BHASIN, AKASHNI (MD)
Entity type:Individual
Prefix:
First Name:AKASHNI
Middle Name:
Last Name:BHASIN
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 1:2311 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-4445
Mailing Address - Country:US
Mailing Address - Phone:414-319-3000
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS PL CB 8116
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6051
Practice Address - Fax:314-454-6225
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1013208000000X
MO2018026723208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000627175OtherANTHEM BCBS
KY000000520932OtherANTHEM BCBS
OH2766734Medicaid
KY7100016570Medicaid
OH2766734Medicaid
KY0641231Medicare PIN
KY000000520932OtherANTHEM BCBS