Provider Demographics
NPI:1205069002
Name:BHATIA, PRIMALJYOT K (MD)
Entity type:Individual
Prefix:
First Name:PRIMALJYOT
Middle Name:K
Last Name:BHATIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PRIMAL
Other - Middle Name:J
Other - Last Name:KAUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:716 MAIDEN CHOICE LN
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5943
Mailing Address - Country:US
Mailing Address - Phone:410-788-2000
Mailing Address - Fax:410-455-9881
Practice Address - Street 1:716 MAIDEN CHOICE LN
Practice Address - Street 2:SUITE 301
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5943
Practice Address - Country:US
Practice Address - Phone:410-788-2000
Practice Address - Fax:410-455-9881
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD040015207RR0500X
PAMT190025207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine