Praveen K Bolarum (NPI# 1073575015, PAC ID# 0648238600) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1073575015 |
| PAC ID by PECOS | 0648238600 |
| Professional Enrollment ID | I20041222000632 |
| Full Name | Praveen K Bolarum |
| Organization Legal Name | PRAVEEN BOLARUM MD LLC |
| Address |
196 Thomas Johnson Dr Suite 135 Frederick MD 21702-4518 |
| Phone Number | 3016946688 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1995 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 9638276199 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210005 | FREDERICK MEMORIAL HOSPITAL |
| 390065 | GETTYSBURG HOSPITAL |
| 210027 | WESTERN MARYLAND REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 6530 Democracy Blvd, Bethesda, MD 20817-1679 | 3015309000 | PRAVEEN BOLARUM MD LLC |
| 196 Thomas Johnson Dr, Suite 135, Frederick, MD 21702-4518 | 3016946688 | PRAVEEN BOLARUM MD LLC |
| 10714 Potomac Tennis Ln, Potomac, MD 20854-4418 | 3012992273 | PRAVEEN BOLARUM MD LLC |
| Organization Legal Name | PRAVEEN BOLARUM MD LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rinku X Mukherjee | Internal Medicine | Praveen Bolarum Md LLC | 196 Thomas Johnson Dr, Suite 135, Frederick, MD 21702-4518 |
| Paola T Haros | Physician Assistant | Praveen Bolarum Md LLC | 10714 Potomac Tennis Ln, Potomac, MD 20854-4418 |
| Street Address |
196 THOMAS JOHNSON DR SUITE 135 |
| City | FREDERICK |
| State | MD |
| Zip | 21702-4518 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William D Strayhorn Iv | Neurology | Comprehensive Neurology Services, Pa | 196 Thomas Johnson Dr, Suite 120, Frederick, MD 21702-4521 |
| Corey Amber Ward | Nurse Practitioner | Comprehensive Neurology Services, Pa | 196 Thomas Johnson Dr, Suite 120, Frederick, MD 21702-4521 |
| Michael G Schmitt | Physical Therapy | 196 Thomas Johnson Dr, Suite 225, Frederick, MD 21702-4528 | |
| Sean T Burke | Neurology | Comprehensive Neurology Services, Pa | 196 Thomas Johnson Dr, Suite 120, Frederick, MD 21702-4521 |
| Rinku X Mukherjee | Internal Medicine | Praveen Bolarum Md LLC | 196 Thomas Johnson Dr, Suite 135, Frederick, MD 21702-4518 |
| Natalia Maria Llanes | Neurology | Comprehensive Neurology Services, Pa | 196 Thomas Johnson Dr, Suite 120, Frederick, MD 21702-4521 |
| William L Janik | Nurse Practitioner | Comprehensive Neurology Services, Pa | 196 Thomas Johnson Dr, Suite 120, Frederick, MD 21702-4521 |
| Madison Elisabeth Nolen | Physician Assistant | Newbridge Spine and Pain Center LLC | 196 Thomas Johnson Dr, Suite 215, Frederick, MD 21702-4527 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kumudhini Hendrix | Anesthesiology | North American Partners In Anesthesia Maryland LLC | 45 Thomas Jefferson Dr, Frederick, MD 21702 |
| Thomas S Davis | Certified Registered Nurse Anesthetist (crna) | North American Partners In Anesthesia Maryland LLC | 45 Thomas Jefferson Dr, Frederick, MD 21702 |
| Debra L Clise | Certified Registered Nurse Anesthetist (crna) | North American Partners In Anesthesia Maryland LLC | 45 Thomas Jefferson Dr, Frederick, MD 21702 |
| Lise Ricotta Asaro | Anesthesiology | North American Partners In Anesthesia Maryland LLC | 45 Thomas Jefferson Dr, Frederick, MD 21702 |
| Susan M Allig | Certified Registered Nurse Anesthetist (crna) | North American Partners In Anesthesia Maryland LLC | 45 Thomas Jefferson Dr, Frederick, MD 21702 |
| Alan S Bronstein | Certified Registered Nurse Anesthetist (crna) | North American Partners In Anesthesia Maryland LLC | 45 Thomas Jefferson Dr, Frederick, MD 21702 |
| Jennifer Lyn Chen | Optometry | Longmeadow Optical, Ltd | 7420 Hayward Rd, Suite 202, Frederick, MD 21702-2507 |
| Dawn Renee Gill | Optometry | Longmeadow Optical, Ltd | 7420 Hayward Rd, Suite 202, Frederick, MD 21702-2507 |
| Allen Gilson | Pulmonary Disease | 6695 Stone Ridge Ct, Frederick, MD 21702-2989 | |
| Gary E Schreiber | Chiropractic | 1446 W Patrick St, Suite 14, Frederick, MD 21702-3277 | |
| Find all physicians in zip 21702 | |||
| City | FREDERICK |
| Zip Code | 21702 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | FREDERICK + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Praveen K Bolarum.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.