Provider Demographics
NPI:1386810711
Name:B.S. BOHRA M.D. P.C.
Entity type:Organization
Organization Name:B.S. BOHRA M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHADUR
Authorized Official - Middle Name:S
Authorized Official - Last Name:BOHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-388-0021
Mailing Address - Street 1:1336 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-2319
Mailing Address - Country:US
Mailing Address - Phone:313-388-0021
Mailing Address - Fax:
Practice Address - Street 1:1336 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-2319
Practice Address - Country:US
Practice Address - Phone:313-388-0021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBB043408207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty