Healthcare Provider Details

I. General information

NPI: 1578745956
Provider Name (Legal Business Name): JAWED MUHAMMAD BHARWANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAWED M BHARWANI MD

II. Dates (important events)

Enumeration Date: 11/28/2007
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 NEWPORT AVE
OMAHA NE
68152-2164
US

IV. Provider business mailing address

7261 MERCY RD
OMAHA NE
68124-2311
US

V. Phone/Fax

Practice location:
  • Phone: 402-817-9592
  • Fax: 402-572-3375
Mailing address:
  • Phone: 402-398-6248
  • Fax: 402-829-8513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2004001469
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number24128
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: