Provider Demographics
NPI:1639129182
Name:BHAT, SALIGRAMA B (MD)
Entity Type:Individual
Prefix:
First Name:SALIGRAMA
Middle Name:B
Last Name:BHAT
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 1:3410 TAMIAMI TRAIL
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952
Mailing Address - Country:US
Mailing Address - Phone:941-629-8006
Mailing Address - Fax:941-629-8283
Practice Address - Street 1:3410 TAMIAMI TRAIL
Practice Address - Street 2:SUITE 2
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952
Practice Address - Country:US
Practice Address - Phone:941-629-8006
Practice Address - Fax:941-629-8283
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0042288207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL08123OtherBCBSFL
FL067620900Medicaid
FL08123OtherBCBSFL
FL08123XMedicare ID - Type Unspecified