Paola T Haros (NPI# 1922510056, PAC ID# 5890054282) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1922510056 |
| PAC ID by PECOS | 5890054282 |
| Professional Enrollment ID | I20180110000740 |
| Full Name | Paola T Haros |
| Organization Legal Name | PRAVEEN BOLARUM MD LLC |
| Address |
10714 Potomac Tennis Ln Potomac MD 20854-4418 |
| Phone Number | 3012992273 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| 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 |
| Address | Phone | Organization |
|---|---|---|
| 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 |
|---|---|---|---|
| Praveen K Bolarum | Family Medicine | Praveen Bolarum Md LLC | 196 Thomas Johnson Dr, Suite 135, Frederick, MD 21702-4518 |
| Rinku X Mukherjee | Internal Medicine | Praveen Bolarum Md LLC | 196 Thomas Johnson Dr, Suite 135, Frederick, MD 21702-4518 |
| Street Address |
10714 POTOMAC TENNIS LN |
| City | POTOMAC |
| State | MD |
| Zip | 20854-4418 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ramani S Nokku | Internal Medicine | 10714 Potomac Tennis Ln, Rockville, MD 20854-4418 | |
| Angela L Novas | Nurse Practitioner | Fried and Wilks, LLC | 10714 Potomac Tennis Ln, Potomac, MD 20854-4418 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laurie Joyce Wenger | Ophthalmology | Potomac Eye Surgeons Pa | 11500 Lake Potomac Dr, Potomac, MD 20854-1223 |
| Lawrence Michael Levinson | Ophthalmology | Potomac Eye Surgeons Pa | 11500 Lake Potomac Dr, Potomac, MD 20854-1223 |
| Janice Hwang | Diagnostic Radiology | Los Robles Radiologic Associates | 12210 Greenbriar Branch Dr, Potomac, MD 20854-1459 |
| Peggy O Heller | Clinical Social Worker | 7715 Whiterim Ter, Potomac, MD 20854-1775 | |
| Gertrude B Summers | Psychologist, Clinical | 10048 Colebrook Ave, Potomac, MD 20854-1807 | |
| David T George | Psychiatry | 10400 Joiners Ln, Potomac, MD 20854-1941 | |
| Holly E Korsvik-wysocki | Diagnostic Radiology | Advanced Radiology Pa | 11913 Tallwood Ct, Potomac, MD 20854-2169 |
| James Yan | Neurology | James Yan, Md Pa | 9322 Sprinklewood Ln, Potomac, MD 20854-2257 |
| Harriet Breslow | Clinical Social Worker | 8712 Harness Trl, Potomac, MD 20854-2553 | |
| Myra Framm | Certified Clinical Nurse Specialist (cns) | 8813 Harness Trl, Potomac, MD 20854-2556 | |
| Find all physicians in zip 20854 | |||
| City | POTOMAC |
| Zip Code | 20854 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | POTOMAC + PHYSICIAN ASSISTANT |
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| 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.