| NPI | 1073575015 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-04-05 |
| Last Updated | 2018-06-12 |
| Mailing Address | 196 Thomas Johnson Dr Ste 135 Frederick, MD 21702-4518 United States Phone: (301) 694-6688 | Fax: (301) 694-8524 📍 View Map |
| Primary Practice Address | 196 Thomas Johnson Dr Ste 135 Frederick, MD 21702 United States Phone: (301) 694-6688 | Fax: (301) 694-8524 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207Q00000X – Family Medicine | MD | D0062223 |
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About NPI 1073575015
Praveen K Bolarum M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1073575015. The primary specialty listed is Family Medicine. The provider is located in Frederick, MD. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-04-05. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1073575015?
NPI 1073575015 belongs to Praveen K Bolarum M.D., a Family Medicine in Frederick, MD. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1073575015 active?
The current status of NPI 1073575015 in the NPPES registry is Active. The record was last updated on 2018-06-12.
What specialty is NPI 1073575015?
NPI 1073575015 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1073575015?
You can verify NPI 1073575015 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1073575015?
The primary practice address on file for NPI 1073575015 is 196 Thomas Johnson Dr Ste 135, Frederick, MD 21702. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1073575015 issued?
NPI 1073575015 was first issued (enumerated) on 2006-04-05. The NPPES record was last updated on 2018-06-12.
Practice Location Map
Praveen K Bolarum is located at 196 Thomas Johnson Dr Ste 135, Frederick, MD. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Praveen K Bolarum. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1073575015. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Family Medicine | D0062223 | MD |