Provider Demographics
NPI:1427055250
Name:DAS, BABULAL (MD)
Entity type:Individual
Prefix:
First Name:BABULAL
Middle Name:
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MILFORD ST
Mailing Address - Street 2:STE 504B
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-6953
Mailing Address - Country:US
Mailing Address - Phone:410-546-5954
Mailing Address - Fax:410-219-3038
Practice Address - Street 1:106 MILFORD ST
Practice Address - Street 2:STE 504B
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6953
Practice Address - Country:US
Practice Address - Phone:410-546-5954
Practice Address - Fax:410-219-3038
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
21728011OtherUHC
0000467701OtherMADE
000799857OtherAMERIHEALTH
510427OtherUSHC
251300OtherBSVA
32014OtherDHP
4393240OtherAETN
00A694M21OtherMBDE
110140803OtherMBRR
50014OtherBSDC
61388104OtherBSMD
191308OtherAMERIGROUP
MD545418200Medicaid
699235800OtherMAMD
30773OtherPP
843455OtherMAMS
191308OtherAMERIGROUP
32014OtherDHP