Provider Demographics
NPI:1609834654
Name:BAHN, CHARLES F (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:BAHN
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 1:4848 BATTERY LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2709
Mailing Address - Country:US
Mailing Address - Phone:301-657-3022
Mailing Address - Fax:
Practice Address - Street 1:4848 BATTERY LN
Practice Address - Street 2:SUITE 102
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2709
Practice Address - Country:US
Practice Address - Phone:301-657-3022
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0031521207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1422OtherBLUE CROSS OF MD NATL ACC
MD1372912OtherCIGNA
MD7458001OtherCARE FIRST BCBS
MD410508OtherBLUE CROSS OF MARYLAND
MD1422OtherBLUE CROSS OF MD NATL ACC
MD479921Medicare ID - Type Unspecified