Provider Demographics
NPI:1427031145
Name:DASS, BHAGWAN (MD)
Entity type:Individual
Prefix:DR
First Name:BHAGWAN
Middle Name:
Last Name:DASS
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 100238
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0238
Mailing Address - Country:US
Mailing Address - Phone:352-294-8278
Mailing Address - Fax:352-265-0379
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-1302
Practice Address - Country:US
Practice Address - Phone:352-294-8278
Practice Address - Fax:352-265-0379
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106428207R00000X, 207RN0300X, 208M00000X
OH35080329D207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001978300Medicaid
OH2331408Medicaid
4091354Medicare ID - Type Unspecified
FL001978300Medicaid
FLCZ799ZMedicare PIN