MEDICARE: ANUPAM BHAVSAR

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	183500000X	Pharmacist	17073	MD

General Provider Information

NPI Number	:	1710282256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANUPAM BHAVSAR

Provider Business Mailing Address
First Line	:	7629 TALL PIN OAK DR
Second Line	:
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6576
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8601 BALTIMORE NATIONAL PIKE
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-4176
Country	:	US
Telephone Number	:	410-480-1377
Fax Number	:

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

Provider Enumeration Date	:	01/13/2011
Last Update Date	:	01/13/2011

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