Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Vladimer Bakhutashvili, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1851895080

Vladimer Bakhutashvili, MD is an Endocrinology in Morgantown, West Virginia. Qualified in 2018, 8 years ago. Practices with Kennedy Medical Group Practice, PC, a 414-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
8
Licensed in
NJ
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 Stadium Dr
Morgantown, WV 26506-7911
Phone: (304) 598-4850
Fax: (304) 598-4871
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 333 Laurel Oak Rd, Voorhees, NJ 08043-4453 — (844) 542-2273

Specialties & licences

Endocrinology, Diabetes & Metabolism Physician (primary) Taxonomy 207RE0101X · Licence 25MA11938600 (NJ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1851895080
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 21, 2018
Last updated in NPPESJuly 13, 2023
Certification dateJuly 13, 2023
Mailing address101 Stadium Dr, Morgantown, WV 26506-7911

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyENDOCRINOLOGY
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Kennedy Medical Group Practice, P.C. — 414 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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