Provider Demographics
NPI:1871560581
Name:BHARAT, YOGENDRA (MD)
Entity type:Individual
Prefix:
First Name:YOGENDRA
Middle Name:
Last Name:BHARAT
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 1:5007 S HOWELL AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-6158
Mailing Address - Country:US
Mailing Address - Phone:414-409-9114
Mailing Address - Fax:833-261-9693
Practice Address - Street 1:2500 W LAYTON AVE STE 170
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221-5433
Practice Address - Country:US
Practice Address - Phone:414-409-9114
Practice Address - Fax:833-261-9693
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27552207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32854700Medicaid
WI32854700Medicaid
D86970Medicare UPIN