Provider Demographics
NPI:1710226014
Name:BAGSIC, JOSEPHINE DAVID
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:DAVID
Last Name:BAGSIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 WYNDHAM DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7391
Mailing Address - Country:US
Mailing Address - Phone:240-575-4289
Mailing Address - Fax:
Practice Address - Street 1:9735 WYNDHAM DR
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-7391
Practice Address - Country:US
Practice Address - Phone:240-575-4289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD219262251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics