Basic Information
| Provider Information | |||||||||
| NPI: | 1902992845 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEHARI | ||||||||
| FirstName: | AJAY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 FAIRMOUNT AVE STE 103 | ||||||||
| Address2: | |||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212865457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104947921 | ||||||||
| FaxNumber: | 4109028247 | ||||||||
| Practice Location | |||||||||
| Address1: | 9103 FRANKLIN SQUARE DR | ||||||||
| Address2: | 300 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212373900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106825282 | ||||||||
| FaxNumber: | 4106825286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 03/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | D64408 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 2084S0012X | D64408 | MD | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine | 207RP1001X | D64408 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207R00000X | D64408 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.