1124276084 NPI number — DR. BHAVPREET SINGH DHAM M.D.

Table of content: DR. BHAVPREET SINGH DHAM M.D. (NPI 1124276084)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124276084 NPI number — DR. BHAVPREET SINGH DHAM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DHAM
Provider First Name:
BHAVPREET
Provider Middle Name:
SINGH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124276084
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 ELMWOOD AVE BOX 278984
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14642-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-784-9277
Provider Business Mailing Address Fax Number:
585-424-7289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
919 WESTFALL RD STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14618-2628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-341-7500
Provider Business Practice Location Address Fax Number:
585-341-7510
Provider Enumeration Date:
09/04/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  288691 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)