Individual
MADHAV H BHAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2510 E DUPONT RD STE 226, FORT WAYNE, IN 46825-1603
(260) 460-3100
(260) 460-3130
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01034970A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0703537
—
OH
05
—
100319640
—
IN
01
—
130005974
RR MEDICARE
IN
05
—
2717800
—
MI
Enumeration date
06/30/2005
Last updated
10/05/2023
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