Provider Demographics
NPI:1578745956
Name:BHARWANI, JAWED MUHAMMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAWED
Middle Name:MUHAMMAD
Last Name:BHARWANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAWED
Other - Middle Name:M
Other - Last Name:BHARWANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:402-398-6248
Mailing Address - Fax:402-829-8513
Practice Address - Street 1:7101 NEWPORT AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2164
Practice Address - Country:US
Practice Address - Phone:402-817-9592
Practice Address - Fax:402-572-3375
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040014692084P0804X
NE241282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO920850080OtherMEDICARE
NE10025382000Medicaid
MO209243401Medicaid
MO209243401Medicaid