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General NPI Number Information
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NPI Number | 1699938696
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Entity Type | Individual
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Provider Name | MARWAN A BAKHEET MD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 02/16/2014
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Provider Practice Location Address
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Address Line | 120 YELLOWSTONE DR NO. 2
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-8109
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Country | US
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Telephone | 646-275-4802
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8355
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22906-8355
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Country | US
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Telephone | 646-275-4802
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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 | 0101254385
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 272174
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License Number State | NY
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