Individual
SHYAM BHAKTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
627 EASTLAND AVE SE STE 301, WARREN, OH 44484-4501
(330) 392-3099
(330) 395-1721
Mailing address
627 EASTLAND AVE SE STE 301, WARREN, OH 44484-4501
(330) 392-3099
(330) 395-1721
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35089165
OH
207RI0011X
Interventional Cardiology Physician
Primary
35089165
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
05
—
2762498
—
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
01
—
9691080
AETNA
OH
Enumeration date
01/30/2007
Last updated
05/14/2025
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