1316383284 NPI number — DR. NITA VASUDEV BHATT MD, MPH

Table of content: DR. NITA VASUDEV BHATT MD, MPH (NPI 1316383284)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316383284 NPI number — DR. NITA VASUDEV BHATT MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BHATT
Provider First Name:
NITA
Provider Middle Name:
VASUDEV
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
F

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:
1316383284
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
627 EDWIN C. MOSES BLVD.
Provider Second Line Business Mailing Address:
WRIGHT STATE UNIVERSITY DEPARTMENT OF PSYCHIATRY
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45417-1461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-223-8840
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
627 EDWIN C. MOSES BLVD.
Provider Second Line Business Practice Location Address:
WRIGHT STATE UNIVERSITY DEPARTMENT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45417-1461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-223-8840
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2013

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: 2084P0800X , with the licence number:  ACKNOWLEDGEMENT LETT , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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