Healthcare Provider Details

I. General information

NPI: 1871828160
Provider Name (Legal Business Name): CHANDRA SHEKHAR BHATI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 S GREENE ST
BALTIMORE MD
21201-1504
US

IV. Provider business mailing address

PO BOX 64226
BALTIMORE MD
21264-4226
US

V. Phone/Fax

Practice location:
  • Phone: 667-214-1718
  • Fax: 410-706-6976
Mailing address:
  • Phone: 667-214-1734
  • Fax: 410-706-6976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberD0092411
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number0101256518
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101256518
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: