Provider Demographics
NPI:1528130085
Name:BHAT, DILEEP S (M D)
Entity type:Individual
Prefix:DR
First Name:DILEEP
Middle Name:S
Last Name:BHAT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 NORTH KIMBALL
Mailing Address - Street 2:SUITE 900
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301
Mailing Address - Country:US
Mailing Address - Phone:605-996-1216
Mailing Address - Fax:605-996-7426
Practice Address - Street 1:2200 NORTH KIMBALL
Practice Address - Street 2:SUITE 900
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301
Practice Address - Country:US
Practice Address - Phone:605-996-1216
Practice Address - Fax:605-996-7426
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD1238208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0009211OtherBLUE CROSS BLUE SHIELD
SD34153OtherSIOUX VALLEY HEALTHCARE
SD1980OtherAVERA HEALTH PLAN
SDS9211OtherRAILROAD MEDICARE
SD036259001OtherDMERC
SD142798OtherAVERA SELECT
SD7500250Medicaid
SD1238OtherDAKOTACARE
SDS9211OtherRAILROAD MEDICARE
SDS9211Medicare ID - Type Unspecified