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General NPI Number Information
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NPI Number | 1922091404
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Entity Type | Individual
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Provider Name | JINAN O BAHIA MD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2005
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 4518 UNION DEPOSIT RD
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City | HARRISBURG
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State | PA
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Zip | 17111-2921
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Country | US
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Telephone | 717-652-5840
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Fax | 717-652-8152
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Provider Business Mailing Address
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Address Line | 4520 UNION DEPOSIT RD
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City | HARRISBURG
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State | PA
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Zip | 17111-2910
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Country | US
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Telephone | 717-652-6105
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Fax | 717-652-2165
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD039287L
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License Number State | PA
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