Healthcare Provider Details

I. General information

NPI: 1144202300
Provider Name (Legal Business Name): BHAVIN R DAVE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 10/04/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 BAY ROAD, UNIT B
DOVER DE
19901-3568
US

IV. Provider business mailing address

640 S. STATE STREET MAIL CODE 3055
DOVER DE
19901-3530
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-9310
  • Fax: 302-744-9312
Mailing address:
  • Phone: 302-744-9310
  • Fax: 302-744-9312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0004966
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberC1-0004966
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: