Bacchus, Rafeena
Bacchus, Rafeena is an individual health care provider with primary practice located at 5900 Waterloo Rd Ste 200 , Columbia MD 21045-2641. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Bacchus, Rafeena can be contacted via phone (410) 740-2900.Contact Information
Primary practice address
5900 Waterloo Rd Ste 200
Columbia MD 21045-2641
Phone: (410) 740-2900
Fax: (410) 992-0732
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | D73688 | Maryland |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | D0073688 | Maryland |
Profile Details
| NPI number | 1336374321 |
|---|---|
| LBN Legal business name | Bacchus, Rafeena |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 20th, 2009 |
| Last updated | Mar 16th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336374321 | NPPES |
| Other | P01102392 | RR MEDICARE PTAN | |
| Other | V8260037 | RR MEDICARE PTAN |
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