Individual
BHAVAGAN S MAGANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
690 MINOT AVE STE 1, AUBURN, ME 04210-3922
(207) 344-2220
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
008618
ME
207L00000X
Anesthesiology Physician
Primary
ME85406
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29222
FL BCBS PROVIDER #
FL
05
—
297670099
—
ME
01
—
300803700
DOL ACS (FECA) W/C
FL
01
—
P00009748
MEDICARE RAILROAD
FL
Enumeration date
08/11/2005
Last updated
12/12/2012
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