Provider Demographics
NPI:1508607722
Name:BAHRU LLC
Entity type:Organization
Organization Name:BAHRU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEMBERE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHRU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-246-3628
Mailing Address - Street 1:43713 RED HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-1628
Mailing Address - Country:US
Mailing Address - Phone:571-246-3628
Mailing Address - Fax:
Practice Address - Street 1:122 MORVEN PARK RD NW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-2024
Practice Address - Country:US
Practice Address - Phone:571-246-3628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty