Individual
DR. KOMAL BHARATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-2844
(215) 214-1425
Mailing address
1601 CHESTNUT ST, 2 LIBERTY PLACE, PHILADELPHIA, PA 19192-0001
(267) 838-2061
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD443523
PA
208M00000X
Hospitalist Physician
Primary
MD443523
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037276
MLHC MEDICARE AA #
PA
01
—
100727800
TPI MEDICAID GROUP
PA
01
—
597586
TPI MEDICARE GROUP PIN
PA
01
—
824305
MLHC B/S AA #:
PA
01
—
CD4829
TPI RAILROAD MEDICARE GROUP
PA
Enumeration date
08/30/2009
Last updated
08/14/2020
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