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NPI Code Detail

MEDICARE: BHAVAGAN S MAGANTI MD

MEDICARE: BHAVAGAN S MAGANTI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianME85406FL
2207L00000XAnesthesiology Physician008618ME

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00009748OTHERFLMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2300803700OTHERFLDOL ACS (FECA) W/C
429222OTHERFLFL BCBS PROVIDER #
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003818923
Entity Type Code : Individual
Provider Name (Legal Business Name) : BHAVAGAN S MAGANTI MD
Provider Business Mailing Address
First Line : 324 GANNETT DR STE 200
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-3266
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 690 MINOT AVE STE 1
Second Line :
City : AUBURN
State : ME
Zip : 04210-3922
Country : US
Telephone Number : 207-344-2220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 12/12/2012

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1063412211 — DR. MATTHEW MURRAY MCLAUGHLIN MD
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Directions to “ BHAVAGAN S MAGANTI MD” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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