Basic Information
| Provider Information | |||||||||
| NPI: | 1750408126 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKHRU | ||||||||
| FirstName: | RITA | ||||||||
| MiddleName: | NANIK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | MEDICAL CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271570001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367162255 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | MEDICAL CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271570001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367162255 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2007 | ||||||||
| LastUpdateDate: | 04/21/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301087853 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 197836 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 197836 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 9095364 | 01 | NC | AETNA | OTHER | Q02429 | 01 | SC | SC MEDICAID | OTHER | 1750408126 | 05 | NC | MEDICAID | 18451 | 01 | NC | BCBS | OTHER | 276211 | 01 | NC | MEDCOST | OTHER | 3056183 | 01 | NC | UHC | OTHER | 1750408126 | 01 | VA | VIRGINIA MEDICAID | OTHER | P01321210 | 01 | NC | RAILROAD MEDICARE | OTHER | 1750408126 | 01 | NC | TRICARE | OTHER |