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General NPI Number Information
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NPI Number | 1417168675
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Entity Type | Individual
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Provider Name | KAMAL GORDHANBHAI BANGORIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2007
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 349 MALCOLM DR
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City | WESTMINSTER
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State | MD
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Zip | 21157-6106
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Country | US
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Telephone | 410-848-2566
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Fax | 410-848-6875
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Provider Business Mailing Address
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Address Line | 1798 ODEN WAY
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City | ELDERSBURG
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State | MD
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Zip | 21784-7095
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Country | US
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Telephone | 443-255-3951
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0065641
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | D0065641
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License Number State | MD
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