Provider Demographics
NPI:1336523638
Name:BHARDWAJ, AMRITA MANOJKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:AMRITA
Middle Name:MANOJKUMAR
Last Name:BHARDWAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 LAURENT DR
Mailing Address - Street 2:APT 801
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5973
Mailing Address - Country:US
Mailing Address - Phone:216-502-6261
Mailing Address - Fax:
Practice Address - Street 1:2500 METROHEALTH DRIVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1998
Practice Address - Country:US
Practice Address - Phone:216-778-4486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program