Provider Demographics
NPI:1386603421
Name:BHARGAVA, PANKAJ (MD)
Entity type:Individual
Prefix:
First Name:PANKAJ
Middle Name:
Last Name:BHARGAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:44 BINNEY ST
Mailing Address - Street 2:D1220 DANA-FARBER CANCER INSTITUTE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-632-6184
Mailing Address - Fax:617-632-5370
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:DANA-FARBER CANCER INSTITUTE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-632-6184
Practice Address - Fax:617-632-5370
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA207770207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4123875OtherCIGNA
AA22040OtherHPHC DFCI ONLY
207770OtherTUFTS
3717077OtherAETNA US HEALTHCARE
A31992OtherMEDICARE
0124389OtherMASSHEALTH
MAJ23168OtherBCBS INDEMITY BC ELECT HM
207770OtherTUFTS