# BHAWNA BAHETHI, MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457685380
- **Authorized official:** BHAWNA BAHETHI MD (ADMIN)
- **Authorized official phone:** (410) 766-8911

## Contact information

- **Practice address:** 1600 CRAIN HWY S, STE 501, GLEN BURNIE, MD 21061-5577
- **Practice address phone:** (410) 766-8911
- **Practice address fax:** (410) 766-8977
- **Mailing address:** 1600 CRAIN HWY S, STE 501, GLEN BURNIE, MD 21061-5577
- **Mailing address phone:** (410) 766-8911
- **Mailing address fax:** (410) 766-8977

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D0051325 | MD | Yes |

## Other

- **Enumeration date:** 09/24/2009
- **Last updated:** 04/06/2011