Healthcare Provider Details

I. General information

NPI: 1346870326
Provider Name (Legal Business Name): AMERICAN PSYCHIATRIC CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2020
Last Update Date: 01/18/2020
Certification Date: 01/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5224 HARFORD RD
BALTIMORE MD
21214-2686
US

IV. Provider business mailing address

5504 COREOPSIS CT
CENTREVILLE VA
20120-3092
US

V. Phone/Fax

Practice location:
  • Phone: 410-670-3076
  • Fax:
Mailing address:
  • Phone: 703-926-0626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RAVIKUMAR BHALAVAT
Title or Position: PRESIDENT
Credential: MD
Phone: 410-670-3076