Provider Demographics
NPI:1811125701
Name:BENDRE, SACHIN VILAS (MD PHD)
Entity type:Individual
Prefix:DR
First Name:SACHIN
Middle Name:VILAS
Last Name:BENDRE
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:830 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-3302
Mailing Address - Country:US
Mailing Address - Phone:304-388-1552
Mailing Address - Fax:304-388-1565
Practice Address - Street 1:830 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-3302
Practice Address - Country:US
Practice Address - Phone:304-388-1552
Practice Address - Fax:304-388-1565
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN0604208000000X
WV02073208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics