Healthcare Provider Details

I. General information

NPI: 1336447325
Provider Name (Legal Business Name): AMRINDER SINGH BHATTI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GYPSY LN INTERNAL MEDICINE DEPTT
YOUNGSTOWN OH
44504-1315
US

IV. Provider business mailing address

465 GYPSY LN APT 308
YOUNGSTOWN OH
44504-1361
US

V. Phone/Fax

Practice location:
  • Phone: 330-884-1000
  • Fax:
Mailing address:
  • Phone: 330-884-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.097631
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.097631
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: