Provider Demographics
NPI:1346245628
Name:BIGHAM, HARRY J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:J
Last Name:BIGHAM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WYMAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6410 ROCKLEDGE DR
Practice Address - Street 2:STE 200
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1830
Practice Address - Country:US
Practice Address - Phone:301-897-5301
Practice Address - Fax:301-564-4289
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038888207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD122018OtherAETNA
MD20668OtherMDIPA
MD495942OtherNCPPO
MD076391800Medicaid
MD12470007OtherBCBS
MDE23101Medicare UPIN
MD122018OtherAETNA