Healthcare Provider Details

I. General information

NPI: 1881432839
Provider Name (Legal Business Name): BHMAT CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14205 PARK CENTER DR STE 201
LAUREL MD
20707-5252
US

IV. Provider business mailing address

6415 ROCKHURST RD
BETHESDA MD
20817-1637
US

V. Phone/Fax

Practice location:
  • Phone: 888-383-5613
  • Fax:
Mailing address:
  • Phone: 561-502-3978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ISIAH COLES
Title or Position: CEO
Credential:
Phone: 561-502-3978