Provider Demographics
NPI:1164641759
Name:BHATI, RAJENDRA SUNAO (MD)
Entity Type:Individual
Prefix:
First Name:RAJENDRA
Middle Name:SUNAO
Last Name:BHATI
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 1:416 COLEGATE DR BLDG 3
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-9549
Mailing Address - Country:US
Mailing Address - Phone:740-568-4814
Mailing Address - Fax:740-374-3165
Practice Address - Street 1:807 FARSON ST STE 126
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1068
Practice Address - Country:US
Practice Address - Phone:740-374-7985
Practice Address - Fax:740-374-7990
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2021-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500161208600000X
FLTRN135542086X0206X
OH350952352086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000714914OtherANTHEM
OH3136823Medicaid
OH000000711856OtherANTHEM
WV3810019471Medicaid
OH000000711856OtherANTHEM
NC251374Medicare UPIN
OH4320361Medicare PIN