1447243746 NPI number — BIHU G SANDHIR M.D.

Table of content: BIHU G SANDHIR M.D. (NPI 1447243746)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447243746 NPI number — BIHU G SANDHIR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANDHIR
Provider First Name:
BIHU
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1447243746
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2110 LEITER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMISBURG
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45342-3598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-384-4838
Provider Business Mailing Address Fax Number:
937-384-4845

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 LINCOLN PARK BLVD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
KETTERING
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45429-3492
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-531-5020
Provider Business Practice Location Address Fax Number:
937-298-4385
Provider Enumeration Date:
08/23/2005

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: 207R00000X , with the licence number:  35071073 , 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)

  • Identifier: 2023198 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00075625 . This is a "MEDICARE RR" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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