Healthcare Provider Details

I. General information

NPI: 1245217975
Provider Name (Legal Business Name): SATINDER S. BHULLAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 GUERNSEY ST
BELLAIRE OH
43906-1540
US

IV. Provider business mailing address

PO BOX 3066
WHEELING WV
26003-0233
US

V. Phone/Fax

Practice location:
  • Phone: 740-676-4623
  • Fax: 304-905-9150
Mailing address:
  • Phone: 740-676-4645
  • Fax: 740-671-6333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35034731
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13693
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: