Provider Demographics
NPI:1548292527
Name:BHAGAT, ALOK (MD)
Entity type:Individual
Prefix:
First Name:ALOK
Middle Name:
Last Name:BHAGAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MEDICAL PARK DR STE LL1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-3207
Mailing Address - Country:US
Mailing Address - Phone:330-364-2700
Mailing Address - Fax:330-364-2770
Practice Address - Street 1:400 MEDICAL PARK DR STE LL1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-3207
Practice Address - Country:US
Practice Address - Phone:330-364-2700
Practice Address - Fax:330-364-2770
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350475352084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH130012218OtherRAILROAD MEDICARE
OH0488682Medicaid
OHBH0513991Medicare ID - Type Unspecified
OH0488682Medicaid