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Individual

AMBARISH PERVAJE BHAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 875-3000
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
(417) 875-3000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2017004685
MO
2085R0202X
Diagnostic Radiology Physician
82840
CT
2085R0202X
Diagnostic Radiology Physician
A120744
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
2017004685
MO

Other

Enumeration date
07/22/2008
Last updated
01/02/2026
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