Provider Demographics
NPI:1609839695
Name:BAMDAD, A PIERRE (MD)
Entity Type:Individual
Prefix:DR
First Name:A PIERRE
Middle Name:
Last Name:BAMDAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:951 COMMERCE PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-4040
Mailing Address - Country:US
Mailing Address - Phone:419-998-4575
Mailing Address - Fax:419-998-4586
Practice Address - Street 1:951 COMMERCE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-4034
Practice Address - Country:US
Practice Address - Phone:419-224-5915
Practice Address - Fax:419-224-5918
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35054123B207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
060064242OtherRR MEDICARE
OH0740970Medicaid
OH0634801OtherMEDICARE NUMBER
E67087Medicare UPIN
060064242OtherRR MEDICARE