Provider Demographics
NPI:1801836762
Name:P S BAINS D O LLC
Entity Type:Organization
Organization Name:P S BAINS D O LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PARAMVIR
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAINS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-947-3015
Mailing Address - Street 1:245 NEAL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9372
Mailing Address - Country:US
Mailing Address - Phone:419-947-3015
Mailing Address - Fax:419-946-1308
Practice Address - Street 1:245 NEAL AVE STE D
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-9372
Practice Address - Country:US
Practice Address - Phone:419-947-3015
Practice Address - Fax:419-946-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3407968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2378949Medicaid
OH2378949Medicaid