Healthcare Provider Details

I. General information

NPI: 1114955283
Provider Name (Legal Business Name): ALOK BHAIJI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 09/15/2021
Certification Date: 09/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18780 BAGLEY RD STE 310
CLEVELAND OH
44130-3304
US

IV. Provider business mailing address

7255 OLD OAK BLVD C111
MIDDLEBURGH HTS OH
44130-3300
US

V. Phone/Fax

Practice location:
  • Phone: 440-884-3033
  • Fax: 440-816-2557
Mailing address:
  • Phone: 440-816-2556
  • Fax: 440-816-2557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number00000000000000000
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35067586B
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: