Mittal, Shama Ravi

Mittal, Shama Ravi is an individual health care provider with primary practice located at 14816 Physicians Ln Suite 152, Rockville MD 20850-3944. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Mittal, Shama Ravi can be contacted via phone (240) 453-0000.

Contact Information

Primary practice address
14816 Physicians Ln Suite 152 Rockville MD 20850-3944
Phone: (240) 453-0000
Fax: (301) 591-4407
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X D061382 Maryland
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D061382 Maryland

Profile Details

NPI number 1508865973
LBN Legal business name Mittal, Shama Ravi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508865973 NPPES
Maryland MEDICAID 002542700

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