Healthcare Provider Details

I. General information

NPI: 1528130085
Provider Name (Legal Business Name): DILEEP S BHAT M D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 NORTH KIMBALL SUITE 900
MITCHELL SD
57301
US

IV. Provider business mailing address

2200 NORTH KIMBALL SUITE 900
MITCHELL SD
57301
US

V. Phone/Fax

Practice location:
  • Phone: 605-996-1216
  • Fax: 605-996-7426
Mailing address:
  • Phone: 605-996-1216
  • Fax: 605-996-7426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberSD1238
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0009211
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerBLUE CROSS BLUE SHIELD
# 2
Identifier34153
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerSIOUX VALLEY HEALTHCARE
# 3
Identifier1980
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerAVERA HEALTH PLAN
# 4
IdentifierS9211
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerRAILROAD MEDICARE
# 5
Identifier036259001
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerDMERC
# 6
Identifier142798
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerAVERA SELECT
# 7
Identifier7500250
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer
# 8
Identifier1238
Identifier TypeOTHER
Identifier StateSD
Identifier IssuerDAKOTACARE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: