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General NPI Number Information
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NPI Number | 1952563454
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Entity Type | Individual
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Provider Name | RAMCHANDUR BAKHTIANI MBBS, MD
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Gender | Male
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Dates
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Enumeration Date | 06/26/2008
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 739 THIMBLE SHOALS BLVD SUITE 801
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-3562
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Country | US
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Telephone | 757-873-1009
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Fax |
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Provider Business Mailing Address
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Address Line | 856 J CLYDE MORRIS BLVD STE A RIVERSIDE MEDICAL GROUP
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-1318
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Country | US
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Telephone | 757-594-4006
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 0101260524
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License Number State | VA
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