Healthcare Provider Details

I. General information

NPI: 1083058226
Provider Name (Legal Business Name): MELANIE JOSEPHINE BUKHARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E EAGER ST
BALTIMORE MD
21202-5533
US

IV. Provider business mailing address

1000 E EAGER ST
BALTIMORE MD
21202-5533
US

V. Phone/Fax

Practice location:
  • Phone: 410-522-9800
  • Fax:
Mailing address:
  • Phone: 410-522-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD82830
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: