Provider Demographics
NPI:1134173396
Name:BHOWMIK, NIHAR R (MD)
Entity type:Individual
Prefix:DR
First Name:NIHAR
Middle Name:R
Last Name:BHOWMIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3901 PLUM LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3519
Mailing Address - Country:US
Mailing Address - Phone:757-465-4664
Mailing Address - Fax:757-399-3731
Practice Address - Street 1:301 GOODE WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2266
Practice Address - Country:US
Practice Address - Phone:757-399-0701
Practice Address - Fax:757-399-3731
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053028207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5811902Medicaid
282827OtherANTHEM BCBS
VA110007071OtherMEDICARE PROVIDER ID
VA110007071OtherMEDICARE PROVIDER ID