Provider Demographics
NPI:1053394130
Name:BHAMBHANI, RITU T (MD)
Entity type:Individual
Prefix:DR
First Name:RITU
Middle Name:T
Last Name:BHAMBHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WALTER WARD BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1284
Mailing Address - Country:US
Mailing Address - Phone:410-569-3333
Mailing Address - Fax:877-595-7180
Practice Address - Street 1:100 WALTER WARD BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1284
Practice Address - Country:US
Practice Address - Phone:410-777-8971
Practice Address - Fax:877-595-7180
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056138207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD129157ZC55OtherMEDICARE PTAN
MD600852OtherCAREFIRST
MD129157ZAAEOtherMEDICARE PTAN
MD1085058OtherCAQH
MD132702000Medicaid
MDF963Medicare ID - Type Unspecified
MD129157ZC55OtherMEDICARE PTAN