MEDICARE: GULAM H BHIMANI M.D.

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	208800000X	Urology Physician	37846	MA

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

General Provider Information

NPI Number	:	1073511994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GULAM H BHIMANI M.D.

Provider Business Mailing Address
First Line	:	340 MAIN ST
Second Line	:	STE 670
City	:	WORCESTER
State	:	MA
Zip	:	01608-1604
Country	:	US
Telephone Number	:	508-754-3566
Fax Number	:	508-438-6368

Provider Business Practice Location Address
First Line	:	70 EMORY ST
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-3142
Country	:	US
Telephone Number	:	508-226-1693
Fax Number	:	508-226-0167

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	10/18/2011

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