Healthcare Provider Details
I. General information
NPI: 1821070947
Provider Name (Legal Business Name): BHARAT G ADROJA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/15/2005
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
930 BELLEFONTE AVE SUITE 105
LOCK HAVEN PA
17745-2754
US
IV. Provider business mailing address
1085 REDWING ROAD
LOCK HAVEN PA
17745-1504
US
V. Phone/Fax
- Phone: 570-748-1550
- Fax: 570-748-1510
- Phone: 570-606-3508
- Fax: 570-748-1510
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | MD073482L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD073482L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: