Nitin Bawa, Pa | |
4476 Legendary Dr Ste 100 Destin FL 32541-5347 | |
(850) 424-7320 | |
(850) 424-7322 |
Full Name | Nitin Bawa, Pa |
---|---|
Speciality | Internal Medicine |
Location | 4476 Legendary Dr Ste 100, Destin, Florida |
Authorized Official Name and Position | Nitin Bawa (PHYSICIAN) |
Authorized Official Contact | 8505344170 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nitin Bawa, Pa 4476 Legendary Dr Ste 100 Destin FL 32541-5347 Ph: (850) 424-7320 | Nitin Bawa, Pa 4476 Legendary Dr Ste 100 Destin FL 32541-5347 Ph: (850) 424-7320 |
NPI Number | 1588846257 |
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Provider Enumeration Date | 12/04/2007 |
Last Update Date | 06/27/2023 |
Medicare PECOS PAC ID | 1557386372 |
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Medicare Enrollment ID | O20051011000811 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588846257 | NPI | - | NPPES |
270726800 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | ME91017 (Florida) | Primary |
Provider Name | Nitin Bawa |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1972536266 PECOS PAC ID: 1052386083 Enrollment ID: I20041007000528 |
Provider Name | Kara Madonna Hyman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023328408 PECOS PAC ID: 4385026749 Enrollment ID: I20220801003127 |
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