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General NPI Number Information
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NPI Number | 1497067847
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Entity Type | Organization
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Legal Business Name | BASHAR PHAROAN MD PA
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 4744 RIDGE RD RIDGE MEDICAL CENTER
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City | NOTTINGHAM
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State | MD
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Zip | 21236-3818
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Country | US
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Telephone | 410-661-9300
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Fax | 443-213-1441
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Provider Business Mailing Address
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Address Line | 4744 RIDGE RD RIDGE MEDICAL CENTER
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City | NOTTINGHAM
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State | MD
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Zip | 21236-3818
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Country | US
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Telephone | 410-661-9300
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Fax | 443-213-1441
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Authorized Official
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Title or Position | OWNER
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Name | DR. BASHAR PHAROAN
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Credential | M.D.
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Telephone | 410-661-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0019637
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License Number State | MD
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