Healthcare Provider Details
I. General information
NPI: 1033491642
Provider Name (Legal Business Name): BHAGIRATHBHAI RAVJIBHAI DHOLARIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/09/2011
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2220 PIERCE AVE
NASHVILLE TN
37232
US
IV. Provider business mailing address
3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US
V. Phone/Fax
- Phone: 615-875-9731
- Fax:
- Phone: 615-875-9731
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | ME118506 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 57995 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: