Healthcare Provider Details

I. General information

NPI: 1588653711
Provider Name (Legal Business Name): ROMI BHASIN M.D., PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4895 OLENTANGY RIVER RD SUITE 100
COLUMBUS OH
43214-1926
US

IV. Provider business mailing address

4895 OLENTANGY RIVER RD SUITE 100
COLUMBUS OH
43214-1926
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-7732
  • Fax: 614-457-4346
Mailing address:
  • Phone: 614-457-7732
  • Fax: 614-457-4346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35.081117
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: