Healthcare Provider Details

I. General information

NPI: 1144290222
Provider Name (Legal Business Name): ATUL L BHAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 RESEARCH PL
NORTH CHELMSFORD MA
01863-2412
US

IV. Provider business mailing address

14 RESEARCH PL
NORTH CHELMSFORD MA
01863-2412
US

V. Phone/Fax

Practice location:
  • Phone: 978-454-0706
  • Fax: 978-970-0454
Mailing address:
  • Phone: 978-454-0706
  • Fax: 978-970-0454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number217236
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number11951
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number11951
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number217236
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: