Individual
DR. BAHAR MITTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
85 N GRAND AVE, FORT THOMAS, KY 41075-1793
(859) 912-7211
(859) 655-6674
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 912-7211
(859) 655-6674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38913
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000363598
BLUESHIELD NUMBER
KY
05
—
0118432
—
OH
05
—
64114523
—
KY
01
—
P01459741
RR MEDICARE
KY
Enumeration date
01/16/2007
Last updated
03/08/2021
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