Provider Demographics
NPI:1114955283
Name:BHAIJI, ALOK (MD)
Entity Type:Individual
Prefix:
First Name:ALOK
Middle Name:
Last Name:BHAIJI
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 1:7255 OLD OAK BLVD
Mailing Address - Street 2:C111
Mailing Address - City:MIDDLEBURGH HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3300
Mailing Address - Country:US
Mailing Address - Phone:440-816-2556
Mailing Address - Fax:440-816-2557
Practice Address - Street 1:18780 BAGLEY RD STE 310
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-3304
Practice Address - Country:US
Practice Address - Phone:440-884-3033
Practice Address - Fax:440-816-2557
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00000000000000000163WW0000X
OH35067586B207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0120694Medicaid
OHBH0803912Medicare ID - Type Unspecified
OH0120694Medicaid