Healthcare Provider Details

I. General information

NPI: 1962359679
Provider Name (Legal Business Name): BAKARIKA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10711 RED RUN BLVD STE 101
OWINGS MILLS MD
21117-5138
US

IV. Provider business mailing address

10711 RED RUN BLVD STE 101
OWINGS MILLS MD
21117-5138
US

V. Phone/Fax

Practice location:
  • Phone: 443-883-8634
  • Fax: 240-565-0741
Mailing address:
  • Phone: 443-883-8634
  • Fax: 240-565-0741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BAKARI CHAKHMAKHASHVILI
Title or Position: PRESIDENT
Credential:
Phone: 443-883-8634