Provider Demographics
NPI:1962415430
Name:BHAMA, PRABHAT KUMAR (MD, MPH, FACS)
Entity type:Individual
Prefix:DR
First Name:PRABHAT
Middle Name:KUMAR
Last Name:BHAMA
Suffix:
Gender:M
Credentials:MD, MPH, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1330 ROCKEFELLER AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1677
Mailing Address - Country:US
Mailing Address - Phone:425-297-5359
Mailing Address - Fax:
Practice Address - Street 1:1330 ROCKEFELLER AVE STE 310
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1677
Practice Address - Country:US
Practice Address - Phone:425-297-5359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61030796207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery