Provider Demographics
NPI:1447399811
Name:DHARAM BIR BATISH, INC.
Entity Type:Organization
Organization Name:DHARAM BIR BATISH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-385-7394
Mailing Address - Street 1:1100 PENNSYLVANIA AVE
Mailing Address - Street 2:P O BOX 1265
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-3539
Mailing Address - Country:US
Mailing Address - Phone:330-385-7394
Mailing Address - Fax:330-385-3386
Practice Address - Street 1:1100 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-3539
Practice Address - Country:US
Practice Address - Phone:330-385-7394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0007450096OtherALL LOCATIONS FOR AETNA
OH2002915Medicaid
OH2002899Medicaid
OH2634206Medicaid
OH9289561Medicare ID - Type Unspecified1100 PENN AND 6TH ST
OH2002899Medicaid