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General NPI Number Information
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NPI Number | 1386061380
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Entity Type | Individual
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Provider Name | ADITHYA D BHAT MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 251 E HURON ST STE 5-704
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City | CHICAGO
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State | IL
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Zip | 60611-2908
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Country | US
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Telephone | 312-695-0061
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Fax | 312-695-9013
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Provider Business Mailing Address
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Address Line | 660 S EUCLID AVE CB 8054
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1010
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Country | US
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Telephone | 800-862-9980
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Fax | 314-362-1185
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2019014864
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License Number State | MO
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