MEDICARE: DR. MASUD R BHATTI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RX0202X	Medical Oncology Physician	35-03-6541-B	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003810847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MASUD R BHATTI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 8500-6536
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-6536
Country	:	US
Telephone Number	:	330-318-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	835 SOUTHWESTERN RUN
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44514-3688
Country	:	US
Telephone Number	:	330-318-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	10/05/2012

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