Praveen Bolarum, Md Llc

LBN: Praveen Bolarum, Md Llc
Praveen Bolarum, Md Llc is an health care organization with primary practice located at 3390 Urbana Pike , Frederick MD 21704-7769. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Praveen Bolarum, Md Llc can be contacted via phone (301) 810-5415, or through Bolarum, Praveen K via phone (301) 694-6688.

Contact Information

Primary practice address
3390 Urbana Pike Frederick MD 21704-7769
Phone: (301) 810-5415
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bolarum, Praveen K Doctor of Medicine (MD)
Phone: (301) 694-6688

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1104395243
LBN Legal business name Praveen Bolarum, Md Llc
DBA Doing business as
Authorized official Bolarum, Praveen K Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 19th, 2018
Last updated Dec 6th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104395243 NPPES
Maryland MEDICAID 408672400

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