Provider Demographics
NPI:1194777094
Name:BHANDARI, RANJAN PRAKASH (MD)
Entity type:Individual
Prefix:
First Name:RANJAN
Middle Name:PRAKASH
Last Name:BHANDARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WELDAY AVE
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-3779
Mailing Address - Country:US
Mailing Address - Phone:740-264-5770
Mailing Address - Fax:740-264-5780
Practice Address - Street 1:100 WELDAY AVE
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3779
Practice Address - Country:US
Practice Address - Phone:740-264-5770
Practice Address - Fax:740-264-5780
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH061547207R00000X
WV18112207R00000X, 207RH0003X
PAMD062692L207R00000X, 207RH0003X
OH35061547207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015777320005Medicaid
P00264765OtherRAILROAD MEDICARE
OH0871203Medicaid
0000000379085OtherANTHEM
WV0077376000Medicaid
PA0015777320005Medicaid
PA054693Medicare PIN
WV0077376000Medicaid
OH0711857Medicare PIN