Provider Demographics
NPI:1801803762
Name:BHATIA, ANIMESH S (DPM)
Entity type:Individual
Prefix:DR
First Name:ANIMESH
Middle Name:S
Last Name:BHATIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 LAZELLE RD E #B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235
Mailing Address - Country:US
Mailing Address - Phone:614-323-6366
Mailing Address - Fax:877-877-4797
Practice Address - Street 1:117 LAZELLE RD E #B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235
Practice Address - Country:US
Practice Address - Phone:614-323-6366
Practice Address - Fax:877-877-4797
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003042213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2030635Medicaid
480030899OtherRAILROAD MEDICARE
OH4027902Medicare PIN
OH2030635Medicaid