Otar Datiashvili, MD
Otar Datiashvili, MD is an Emergency Medicine in Bloomington, Indiana. Graduated from State University of New York at Stony Brook, School of Medicine in 2008, 18 years ago. Practices with Methodist South Emergency Physicians, PLLC, a 49-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and New York.
- Years since qualifying
- 18
- Trained at
- State University of New York at Stony Brook, School of Medicine
- Licensed in
- IN, NY
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
2651 E Discovery PkwyBloomington, IN 47408-9059
Phone: (812) 353-9515
Fax: (812) 353-9275
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 60 Roberts Dr Ste 313, North Adams, MA 01247-3254 — (413) 398-5509
Specialties & licences
| Emergency Medicine Physician (primary) | Taxonomy 207P00000X · Licence 01093706A (IN) |
|---|---|
| Emergency Medicine Physician | Taxonomy 207P00000X · Licence 273598-1 (NY) |
Record details
| NPI number | 1083096572 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | Yes |
| NPI enumerated | June 22, 2015 |
| Last updated in NPPES | March 5, 2025 |
| Certification date | March 5, 2025 |
| Mailing address | 250 N Shadeland Ave, Indianapolis, IN 46219-4959 |
Medicare enrollment
| Medicare specialty | EMERGENCY MEDICINE |
|---|---|
| Medical school | STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE |
| Graduated | 2008 (18 years in practice) |
| Group practice | Methodist South Emergency Physicians, Pllc — 49 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 6 on file with Medicare |
Other providers in Bloomington
-
Brandon W Bowdoin, DO
2651 E Discovery Pkwy, Bloomington, IN 47408-9059 · (812) 353-9515
-
Dr. Christina M Cabott, DO
601 W 2nd St, Bloomington, IN 47403-2317 · (812) 336-1690
-
Drew T Carlton, MD
2651 E Discovery Pkwy, Bloomington, IN 47408-9059 · (812) 353-9515
-
Dr. Wendy Conger, MD
601 W 2nd St, Bloomington, IN 47403-2317 · (812) 353-6821
-
Gregory Dorilus, MD
2651 E Discovery Pkwy, Bloomington, IN 47408-9059 · (812) 353-9515
-
Dr. David A Dwyer, MD
601 W 2nd St, Bloomington, IN 47403-2317 · (812) 353-9515
-
Emergency Medicine Professionals of Indiana LLC
4011 So Monroe Medical Park Blvd, Bloomington, IN 47403-9765 · (812) 824-5700
-
Ethan Paul Farmer, DO
2651 E Discovery Pkwy, Bloomington, IN 47408-9059 · (812) 353-9515