Provider Demographics
NPI:1508925157
Name:KAMDAR, BHARATI (MD)
Entity Type:Individual
Prefix:DR
First Name:BHARATI
Middle Name:
Last Name:KAMDAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 KELSEY CT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2767
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7345 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4415
Practice Address - Country:US
Practice Address - Phone:937-433-4877
Practice Address - Fax:937-433-4975
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-1709208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH31-1368453OtherTAXPAYER IDENTIFICATION
OH0909824Medicaid
OH12-20103OtherUNITED HEALTHCARE
OH000000017166OtherANTHEM BLUE CROSS
OHC74647Medicare UPIN