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General NPI Number Information
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NPI Number | 1154531952
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Entity Type | Individual
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Provider Name | SUVEER DEEPAK BAGWE MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 420 N JAMES RD
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City | COLUMBUS
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State | OH
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Zip | 43219-1834
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Country | US
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Telephone | 614-257-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 7190 FERNRIDGE DR
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City | NEW ALBANY
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State | OH
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Zip | 43054-8423
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Country | US
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Telephone | 612-868-3142
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 35.152141
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 54038
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License Number State | MN
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