Provider Demographics
NPI:1235161951
Name:BHATT, SHARAD H (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARAD
Middle Name:H
Last Name:BHATT
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 1:907 S MAIN ST
Mailing Address - Street 2:PO BOX 2367
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-3625
Mailing Address - Country:US
Mailing Address - Phone:330-494-7302
Mailing Address - Fax:330-494-0830
Practice Address - Street 1:907 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-3625
Practice Address - Country:US
Practice Address - Phone:330-494-7302
Practice Address - Fax:330-494-0830
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350607912084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0920356Medicaid
OHBH4226271Medicare PIN
OH0920356Medicaid