Provider Demographics
NPI:1356333546
Name:OZA, BHARAT (MD)
Entity Type:Individual
Prefix:
First Name:BHARAT
Middle Name:
Last Name:OZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BHARAT
Other - Middle Name:
Other - Last Name:OZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:656 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-2240
Mailing Address - Country:US
Mailing Address - Phone:330-308-8811
Mailing Address - Fax:
Practice Address - Street 1:656 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-2240
Practice Address - Country:US
Practice Address - Phone:330-308-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-41333-01208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0345684Medicaid
0ZO440263Medicare ID - Type Unspecified
OH0345684Medicaid