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General NPI Number Information
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NPI Number | 1538213715
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Entity Type | Organization
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Legal Business Name | HAGERSTOWN EAR NOSE & THROAT ASSOCIATES
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 10/23/2008
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Provider Practice Location Address
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Address Line | 363 S CLEVELAND AVE SUITE 202
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5747
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Country | US
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Telephone | 301-790-0444
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Fax | 301-739-3275
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Provider Business Mailing Address
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Address Line | 363 S CLEVELAND AVE SUITE 202
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City | HAGERSTOWN
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State | MD
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Zip | 21740-5747
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Country | US
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Telephone | 301-790-0444
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Fax | 301-739-3275
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Authorized Official
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Title or Position | PRESIDENT
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Name | BIBHAS C BANDY
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Credential | M.D.
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Telephone | 301-790-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | D0015485
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License Number State | MD
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