Provider Demographics
NPI:1639105109
Name:BAGHEL, ASHOK (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name:BAGHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HILANDER DR
Mailing Address - Street 2:
Mailing Address - City:LOUDONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2605
Mailing Address - Country:US
Mailing Address - Phone:518-301-1734
Mailing Address - Fax:
Practice Address - Street 1:9 HILANDER DR
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12211-2605
Practice Address - Country:US
Practice Address - Phone:518-301-1734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198555207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01616559Medicaid
NY01616559Medicaid
G04509Medicare UPIN