Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
OTAR DATIASHVILI, MD
Active Sole ProprietorOTAR DATIASHVILI, MD is a Emergency Medicine healthcare provider located in BLOOMINGTON, Indiana. NPI 1083096572 is currently active in the NPPES registry. Verify at CMS.
Emergency Medicine · BLOOMINGTON, IN
Registration Details
- NPI Number
- 1083096572
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 22, 2015 (11.132105299478 yrs)
- Last Updated
- Mar 5, 2025
- Licenses
-
01093706A (IN)273598-1 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2651 E DISCOVERY PKWYBLOOMINGTON, IN, 474089059Browse IN providers · Browse ZIP 47408
- Phone
- 8123539515
- Fax
- 8123539275
- Primary Specialty
-
Emergency Medicine
207P00000X
- Additional Specialty
- Emergency Medicine
Other Emergency Medicine Providers in BLOOMINGTON, IN
| Name | Credential | NPI |
|---|---|---|
| MATTHEW S REEVES | DO | 1902801798 |
| RONALD C JENSON | DO | 1043297278 |
| KATHERINE MOSHER HILLER | MD | 1841265147 |
| DR. CHRISTINA M CABOTT | DO | 1073562518 |
| LEIGH A. HALPERN | MD | 1508810847 |
| DR. JOHN D RAY | MD | 1326074303 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.