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General NPI Number Information
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NPI Number | 1295738250
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Entity Type | Individual
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Provider Name | GREGORY A BAHTIARIAN DO
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 700 UNIVERSE BLVD
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City | JUNO BEACH
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State | FL
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Zip | 33408-2657
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Country | US
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Telephone | 561-694-6212
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Fax | 888-873-9708
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Provider Business Mailing Address
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Address Line | 4565 ARTESA WAY S
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33418-6790
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Country | US
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Telephone | 302-542-3171
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C20005296
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS19663
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License Number State | FL
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