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General NPI Number Information
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NPI Number | 1386810711
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Entity Type | Organization
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Legal Business Name | B.S. BOHRA M.D. P.C.
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 1336 SOUTHFIELD RD
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City | LINCOLN PARK
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State | MI
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Zip | 48146-2319
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Country | US
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Telephone | 313-388-0021
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Fax |
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Provider Business Mailing Address
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Address Line | 1336 SOUTHFIELD RD
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City | LINCOLN PARK
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State | MI
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Zip | 48146-2319
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Country | US
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Telephone | 313-388-0021
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BAHADUR S BOHRA
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Credential | M.D.
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Telephone | 313-388-0021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | BB043408
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License Number State | MI
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