MEDICARE: DR. BOBBY BATRA M.D.

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
1	208000000X	Pediatrics Physician	4301078214	MI
2	208000000X	Pediatrics Physician	D0068828	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154392611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BOBBY BATRA M.D.

Provider Business Mailing Address
First Line	:	119 HUNTS BLUFF
Second Line	:
City	:	SPARKS GLENCOE
State	:	MD
Zip	:	21152
Country	:	US
Telephone Number	:	443-708-8882
Fax Number	:

Provider Business Practice Location Address
First Line	:	4924 CAMPBELL BLVD
Second Line	:	SUITE 200
City	:	BALTIMORE
State	:	MD
Zip	:	21236-5908
Country	:	US
Telephone Number	:	443-442-2300
Fax Number	:	443-442-2338

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	04/04/2013

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