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Organization

SANJAY BHARTI MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAMA SUBBA RAO RAO KADIYALA (BUSINESS STRATEGY MANAGER)
(304) 363-3714
Entity
Organization

Contact information

Practice address
51 SOUTHLAND DR STE 2400, FAIRMONT, WV 26554-2247
(304) 363-3714
(304) 363-6850
Mailing address
51 SOUTHLAND DR STE 2400, FAIRMONT, WV 26554-2247
(304) 363-3714
(304) 363-6850

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19609
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000332087
MS BCBS
WV
05
0015224000
WV
01
001811060
BS PAY TO NUMBER
WV
01
110236001
RR MC
WV
05
3810016962
WV
01
5622758
AETNA
WV
Enumeration date
03/06/2007
Last updated
12/09/2024
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