Provider Demographics
NPI:1225044928
Name:BAWA, AVNEET K (MD)
Entity Type:Individual
Prefix:DR
First Name:AVNEET
Middle Name:K
Last Name:BAWA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:11908 DARNESTOWN RD
Mailing Address - Street 2:SUITES G & H
Mailing Address - City:N POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2295
Mailing Address - Country:US
Mailing Address - Phone:301-990-6333
Mailing Address - Fax:301-519-0474
Practice Address - Street 1:11908 DARNESTOWN RD
Practice Address - Street 2:SUITES G & H
Practice Address - City:N POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2295
Practice Address - Country:US
Practice Address - Phone:301-990-6333
Practice Address - Fax:301-519-0474
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
MDD00403822080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD069051100Medicaid