Healthcare Provider Details

I. General information

NPI: 1306166442
Provider Name (Legal Business Name): VINAY KUMAR BHATIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 05/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD RADIOLOGY DEPARTMENT
MIAMI BEACH FL
33140-2948
US

IV. Provider business mailing address

MEDICAL CENTER BLVD RADIOLOGY DEPARTMENT
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 305-535-7901
  • Fax:
Mailing address:
  • Phone: 336-716-2255
  • Fax: 336-716-3202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2015-00245
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: