Individual
DR. JAGDEV R BHATOYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 W BROWN ST, WAUPUN, WI 53963-1702
(920) 926-8332
(920) 926-8370
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
34203
WI
208M00000X
Hospitalist Physician
Primary
34203
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014110
—
WI
01
—
1326349135
CMH SB NPI
WI
01
—
1851477913
NPI CMH
WI
05
—
31964300
—
WI
01
—
390848401050
ANTHEM
WI
Enumeration date
08/05/2006
Last updated
03/07/2023
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