Provider Demographics
NPI:1770535171
Name:TOLIA, BHARAT (MD)
Entity type:Individual
Prefix:
First Name:BHARAT
Middle Name:
Last Name:TOLIA
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 1:2550 S TELEGRAPH RD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0950
Mailing Address - Country:US
Mailing Address - Phone:248-334-0115
Mailing Address - Fax:248-334-3338
Practice Address - Street 1:2550 S TELEGRAPH RD
Practice Address - Street 2:SUITE 235
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0950
Practice Address - Country:US
Practice Address - Phone:248-334-0115
Practice Address - Fax:248-334-3338
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010410392084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1379674Medicaid
MI1379674Medicaid
0P32440Medicare PIN