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PRAVEEN BOLARUM, MD LLC
NPI 1104395243
Family Medicine in Frederick, MD

Active since November 19, 2018
3390 URBANA PIKE, FREDERICK, MD 21704(301) 810-5415 Get Directions Write a Review

NPPES record last updated: December 6, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 6, 2018, Nov 19, 2018 (2 updates tracked since 2018).

About Praveen Bolarum, Md Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRAVEEN BOLARUM, MD LLC (NPI 1104395243) is a healthcare organization registered as a family medicine in Frederick, Maryland and active in the NPI registry since November 2018. The organization maintains a secondary practice location in Frederick and lists Praveen K Bolarum, Provider, as its authorized official.

NPPES Registry Identity

NPI1104395243
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRAVEEN BOLARUM, MD LLC
Location Address3390 URBANA PIKEFrederick, MD 21704-7769
Mailing Address3390 Urbana PikeFrederick, MD 21704-7769 · (301) 694-6688
Phone(301) 810-5415
Organization SubpartNo
Authorized OfficialPraveen K BolarumProvider · (301) 694-6688
Enumeration DateNovember 19, 2018
Last NPPES UpdateDecember 6, 20182 updates tracked since enumeration
✔ NPI 1104395243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3390 URBANA PIKE, Frederick, MD 21704
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Secondary Practice Location 1

Location 1196 Thomas Johnson Dr Ste 135Frederick, MD 21702-4518 · Phone (301) 694-6688

Other Identifiers 1

Medicaid408672400MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

I A M THERAPEUTIC
Social Worker (Clinical)
3390 URBANA PIKE
FREDERICK, MD 21704
Frederick County (240) 702-6939
MARK SPRINGSTON, PHD
Psychologist
3390 URBANA PIKE
FREDERICK, MD 21704
Frederick County (301) 788-5351
MS. MICHELE LEE MCCARTNEY LCSW-C, LICSW
Social Worker (Clinical)
3390 URBANA PIKE
FREDERICK, MD 21704
Frederick County (240) 702-6939

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Praveen Bolarum, MD LLC's NPI number?

The NPI number for Praveen Bolarum, MD LLC is 1104395243. It was assigned to this organization in the NPPES registry on November 19, 2018.

Where is Praveen Bolarum, MD LLC located?

Praveen Bolarum, MD LLC is located at 3390 Urbana Pike, Frederick, MD 21704. The listed phone number is (301) 810-5415.

What is Praveen Bolarum, MD LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Praveen Bolarum, MD LLC was last updated on December 6, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.