Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | D0040382 | MD |
NPI | 1225044928 |
---|---|
Provider Name | Dr. Avneet K Bawa |
First Address | N Potomac, MD 20878-2295 |
Second Address | N Potomac, MD 20878-2295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
069051100 | (05) | MD |