Healthcare Provider Details

I. General information

NPI: 1689602906
Provider Name (Legal Business Name): NALINI BHARGAVA M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 MAIDEN CHOICE LN SUITE 350
BALTIMORE MD
21228-3680
US

IV. Provider business mailing address

817 MAIDEN CHOICE LN SUITE 350
BALTIMORE MD
21228-3680
US

V. Phone/Fax

Practice location:
  • Phone: 410-242-9001
  • Fax: 410-242-9003
Mailing address:
  • Phone: 410-242-9001
  • Fax: 410-242-9003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberD19473
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: