Basic Information
| Provider Information | |||||||||
| NPI: | 1407968696 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAHEKAR | ||||||||
| FirstName: | AMOL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 ROBESON ST STE 301 | ||||||||
| Address2: | FAYETTEVILLE HEART CENTER PC | ||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283055641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104844100 | ||||||||
| FaxNumber: | 9104844179 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 ROBESON ST STE 301 | ||||||||
| Address2: | FAYETTEVILLE HEART CENTER PC | ||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283055641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104844100 | ||||||||
| FaxNumber: | 9104844179 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 10/01/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036.120194 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | MD.205342 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 22531 | MS | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | 2013-01748 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 6116067 | 01 | MS | HEALTHSPRINGS | OTHER | 7840774 | 01 | MS | CIGNA | OTHER | 9210147 | 01 | MS | AETNA | OTHER | 2910363 | 01 | MS | UNITED HEALTHCARE | OTHER |