MEDICARE: DR. ERVIND SRIRAM BHOGTE 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	2086S0102X	Surgical Critical Care Physician	MD038703	DC
2	208600000X	Surgery Physician	MD038703	DC
3	208600000X	Surgery Physician	D0073682	MD
4	2086S0102X	Surgical Critical Care Physician	D0073682	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	:	1649437468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERVIND SRIRAM BHOGTE M.D.

Provider Business Mailing Address
First Line	:	100 HOSPITAL RD
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-4017
Country	:	US
Telephone Number	:	410-414-4791
Fax Number	:	410-535-8417

Provider Business Practice Location Address
First Line	:	110 HOSPITAL RD STE 210
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-4040
Country	:	US
Telephone Number	:	410-414-9017
Fax Number	:	443-771-8113

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

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	01/16/2024

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