Provider Demographics
NPI:1083024459
Name:JADHAO, YOGESH (MD)
Entity Type:Individual
Prefix:
First Name:YOGESH
Middle Name:
Last Name:JADHAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SOUTH FRONT STREET
Mailing Address - Street 2:BRADY BUILDING 3, SUITE # 3C
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104
Mailing Address - Country:US
Mailing Address - Phone:717-231-8506
Mailing Address - Fax:717-231-8535
Practice Address - Street 1:205 SOUTH FRONT STREET
Practice Address - Street 2:BRADY BUILDING 3, SUITE # 3C
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104
Practice Address - Country:US
Practice Address - Phone:717-231-8506
Practice Address - Fax:717-231-8535
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH130372207R00000X, 208M00000X
PAMT205942207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist