Healthcare Provider Details

I. General information

NPI: 1790939528
Provider Name (Legal Business Name): RUPEN P BAXI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 GREENWAY CENTER DR STE 410
GREENBELT MD
20770-3597
US

IV. Provider business mailing address

7501 GREENWAY CENTER DR STE 410
GREENBELT MD
20770-3597
US

V. Phone/Fax

Practice location:
  • Phone: 240-616-3934
  • Fax: 240-616-3952
Mailing address:
  • Phone: 240-616-3934
  • Fax: 240-616-3952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number276786
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD0082181
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0101263167
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: