Healthcare Provider Details

I. General information

NPI: 1588348254
Provider Name (Legal Business Name): VIRAJ BHATT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AULTMAN HOSPITAL 2600 SIXTH ST. S.W.
CANTON OH
44710
US

IV. Provider business mailing address

AULTMAN HOSPITAL 2600 SIXTH ST. S.W.
CANTON OH
44710
US

V. Phone/Fax

Practice location:
  • Phone: 330-363-6326
  • Fax:
Mailing address:
  • Phone: 330-363-6326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME179157
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: