Provider Demographics
NPI:1760591911
Name:BUEGE, ALPA (PT)
Entity Type:Individual
Prefix:
First Name:ALPA
Middle Name:
Last Name:BUEGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALPA
Other - Middle Name:
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1814 WAGNER FARM RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-2044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 MEDSTAR BLVD STE 325
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-1817
Practice Address - Country:US
Practice Address - Phone:410-877-8078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD444503100Medicaid
MDP00819181OtherMEDICARE RR
MD444503100Medicaid