Provider Demographics
NPI:1194803122
Name:DIXIT, SANJAY BALWANT (MD)
Entity type:Individual
Prefix:
First Name:SANJAY
Middle Name:BALWANT
Last Name:DIXIT
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:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-284-4060
Mailing Address - Fax:724-284-4144
Practice Address - Street 1:127 ONEIDA VALLEY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2239
Practice Address - Country:US
Practice Address - Phone:724-968-5355
Practice Address - Fax:724-285-1274
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427959207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102580870Medicaid
PA111428SLVMedicare PIN