Dirk Bradley Bahoravitch, MSN, CRNA
Dirk Bradley Bahoravitch, MSN, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Provo, Utah. Qualified in 2016, 10 years ago. Practices with Main Street Anesthesia of New Mexico, LLC, a 228-clinician group and accepts Medicare assignment. Licensed in Idaho.
- Years since qualifying
- 10
- Licensed in
- ID
- In the registry since
- 2016
What do these letters mean?
Practice location Address checks out
1067 N 500 WProvo, UT 84604-3305
Phone: (801) 374-0354
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Certified Registered Nurse Anesthetist (primary) | Taxonomy 367500000X · Licence 53485 (ID) |
|---|
Record details
| NPI number | 1184083826 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MSN , CRNA |
| Sole proprietor | Yes |
| NPI enumerated | February 22, 2016 |
| Last updated in NPPES | January 19, 2021 |
| Certification date | January 19, 2021 |
Medicare enrollment
| Medicare specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
|---|---|
| Medical school | OTHER |
| Graduated | 2016 (10 years in practice) |
| Group practice | Main Street Anesthesia Of New Mexico, Llc — 228 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Provo
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Sarah Ward Barnaby, CRNA
1034 N 500 W, Provo, UT 84604-3380 · (801) 727-2056
-
Chase Bazil, CRNA
1900 N State St Ste 105, Provo, UT 84604-1354 · (801) 655-5245
-
Shelby Lyn Beck
1067 N 500 W, Provo, UT 84604-3305 · (801) 374-0354
-
David B Farnworth, CRNA
1067 N 500 W, Provo, UT 84604-3305 · (801) 375-8049