1386606234 NPI number — BIBHAS C BANDY M.D.

Table of content: BIBHAS C BANDY M.D. (NPI 1386606234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386606234 NPI number — BIBHAS C BANDY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BANDY
Provider First Name:
BIBHAS
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386606234
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
363 S CLEVELAND AVE
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
HAGERSTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21740-5747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-790-0444
Provider Business Mailing Address Fax Number:
301-739-3275

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
363 S CLEVELAND AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21740-5747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-790-0444
Provider Business Practice Location Address Fax Number:
301-739-3275
Provider Enumeration Date:
04/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  D0015485 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 710031100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: E4250001 . This is a "FEDERAL BLUE SHIELD" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 221028 . This is a "MAMSI HEALTH PLANS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 041923465A . This is a "TRAVELERS MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: C043 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 08357440005 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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