MEDICARE: BABAK BEHTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD071238-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023075090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BABAK BEHTA MD

Provider Business Mailing Address
First Line	:	1533 COMMERCE AVE STE 2
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17015-9128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1533 COMMERCE AVE STE 2
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17015-9128
Country	:	US
Telephone Number	:	717-960-8956
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	10/30/2020

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Directions to “ BABAK BEHTA MD” Practice Location

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