Provider Demographics
NPI:1780001891
Name:ALLAM, BHARAT REDDY (DO)
Entity type:Individual
Prefix:
First Name:BHARAT
Middle Name:REDDY
Last Name:ALLAM
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:73 PARK ST
Mailing Address - Street 2:FL 3
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2903
Mailing Address - Country:US
Mailing Address - Phone:973-746-0595
Mailing Address - Fax:973-746-1848
Practice Address - Street 1:73 PARK ST
Practice Address - Street 2:FL 3
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2903
Practice Address - Country:US
Practice Address - Phone:973-746-0595
Practice Address - Fax:973-746-1848
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09996800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine