Provider Demographics
NPI:1417948274
Name:BHAT, MOHAN RAMA (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAN
Middle Name:RAMA
Last Name:BHAT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2027 LEBANON CHURCH RD
Mailing Address - Street 2:CENTURY III MEDICAL ASSOCIATES
Mailing Address - City:WEST MIFFLIN
Mailing Address - State:PA
Mailing Address - Zip Code:15122-2461
Mailing Address - Country:US
Mailing Address - Phone:412-655-6403
Mailing Address - Fax:412-655-6400
Practice Address - Street 1:2027 LEBANON CHURCH RD
Practice Address - Street 2:CENTURY III MEDICAL ASSOCIATES
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2461
Practice Address - Country:US
Practice Address - Phone:412-655-6403
Practice Address - Fax:412-655-6400
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD425421207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011895920001Medicaid
PACG1496Medicare PIN
PA1011895920001Medicaid
PA086819R7RMedicare PIN
PAP00220204Medicare PIN