Provider Demographics
NPI:1407135643
Name:BOWARSHI, MHD KHALED (MD)
Entity Type:Individual
Prefix:DR
First Name:MHD KHALED
Middle Name:
Last Name:BOWARSHI
Suffix:
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 1:26843 TANIC DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4618
Mailing Address - Country:US
Mailing Address - Phone:813-867-2378
Mailing Address - Fax:
Practice Address - Street 1:26843 TANIC DR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4618
Practice Address - Country:US
Practice Address - Phone:813-867-2378
Practice Address - Fax:833-214-9581
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1384162084P0800X, 2084P0800X
WV26715208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1407406366OtherGROUP NPI
FL105751500Medicaid