Provider Demographics
NPI:1659486199
Name:BHALODI, ASHOK V (MD)
Entity Type:Individual
Prefix:
First Name:ASHOK
Middle Name:V
Last Name:BHALODI
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 1:140 N SHERMAN CT
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-5863
Mailing Address - Country:US
Mailing Address - Phone:570-501-7020
Mailing Address - Fax:570-501-7028
Practice Address - Street 1:140 N SHERMAN CT
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-5863
Practice Address - Country:US
Practice Address - Phone:570-501-7020
Practice Address - Fax:570-501-7028
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV14899208800000X
PAMD036656E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0129818000Medicaid
WVD71730Medicare UPIN
WV0129818000Medicaid