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General NPI Number Information
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NPI Number | 1790758241
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Entity Type | Individual
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Provider Name | VINOD SAGAR BHATARA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 2616 S MINNESOTA AVE, STE 5
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City | SIOUX FALLS
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State | SD
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Zip | 57105
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Country | US
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Telephone | 605-323-7976
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Fax |
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Provider Business Mailing Address
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Address Line | 2116 S MINNESOTA AVE STE 5
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City | SIOUX FALLS
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State | SD
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Zip | 57105-3750
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Country | US
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Telephone | 605-323-7976
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Fax | 605-322-6475
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2449
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License Number State | SD
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