Healthcare Provider Details

I. General information

NPI: 1205069002
Provider Name (Legal Business Name): PRIMALJYOT K BHATIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PRIMAL J KAUR M.D.

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 03/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 MAIDEN CHOICE LN SUITE 301
CATONSVILLE MD
21228-5943
US

IV. Provider business mailing address

716 MAIDEN CHOICE LN SUITE 301
CATONSVILLE MD
21228-5943
US

V. Phone/Fax

Practice location:
  • Phone: 410-788-2000
  • Fax: 410-455-9881
Mailing address:
  • Phone: 410-788-2000
  • Fax: 410-455-9881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT190025
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD040015
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: