MEDICARE: DAVID EUGENE BACHA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RR0500X	Rheumatology Physician	48308	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00238133	OTHER	OH	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366448482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID EUGENE BACHA M.D.

Provider Business Mailing Address
First Line	:	471 N. CLEVELAND MASSILLON RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333
Country	:	US
Telephone Number	:	330-668-4045
Fax Number	:	330-668-2492

Provider Business Practice Location Address
First Line	:	471 N. CLEVELAND MASSILLON RD.
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333
Country	:	US
Telephone Number	:	330-668-4045
Fax Number	:	330-668-2492

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	03/07/2023

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