Provider Demographics
NPI:1740487156
Name:BHATTI, SAMAN (OD)
Entity type:Individual
Prefix:MRS
First Name:SAMAN
Middle Name:
Last Name:BHATTI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3326 PEDDICOAT CT
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163-1137
Mailing Address - Country:US
Mailing Address - Phone:410-905-3516
Mailing Address - Fax:
Practice Address - Street 1:815 GOUCHER BLVD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5602
Practice Address - Country:US
Practice Address - Phone:410-296-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1907152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist