MEDICARE: BASHAR PHAROAN MD PA

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	174400000X	Specialist	D0019637	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	:	1497067847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BASHAR PHAROAN MD PA

Provider Business Mailing Address
First Line	:	4744 RIDGE RD
Second Line	:	RIDGE MEDICAL CENTER
City	:	NOTTINGHAM
State	:	MD
Zip	:	21236-3818
Country	:	US
Telephone Number	:	410-661-9300
Fax Number	:	443-213-1441

Provider Business Practice Location Address
First Line	:	4744 RIDGE RD
Second Line	:	RIDGE MEDICAL CENTER
City	:	NOTTINGHAM
State	:	MD
Zip	:	21236-3818
Country	:	US
Telephone Number	:	410-661-9300
Fax Number	:	443-213-1441

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BASHAR PHAROAN
Credential	:	M.D.
Telephone Number	:	410-661-9300

Provider Enumeration Date	:	07/13/2010
Last Update Date	:	07/13/2010

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Directions to “BASHAR PHAROAN MD PA ” Practice Location

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