Individual
RAFEENA BACCHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5900 WATERLOO RD STE 200, COLUMBIA, MD 21045-2641
(410) 740-2900
(410) 992-0732
Mailing address
7580 BUCKINGHAM BLVD STE 220, HANOVER, MD 21076-3210
(410) 729-5100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0073688
MD
208M00000X
Hospitalist Physician
D73688
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01102392
RR MEDICARE PTAN
—
01
—
V8260037
CAREFIRST
—
Enumeration date
05/20/2009
Last updated
03/16/2023
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