Provider Demographics
NPI:1740480300
Name:BACHUWA, RIMA (MD)
Entity type:Individual
Prefix:
First Name:RIMA
Middle Name:
Last Name:BACHUWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 CROCKER RD STE 130
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-7603
Mailing Address - Country:US
Mailing Address - Phone:440-871-2222
Mailing Address - Fax:440-249-4111
Practice Address - Street 1:2211 CROCKER RD STE 130
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-7603
Practice Address - Country:US
Practice Address - Phone:440-871-2222
Practice Address - Fax:440-249-4111
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-097973207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0054272Medicaid
OH0054272Medicaid