Provider Demographics
NPI:1063487593
Name:PARANJAPE, SHRUTI M (MD)
Entity Type:Individual
Prefix:DR
First Name:SHRUTI
Middle Name:M
Last Name:PARANJAPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHRUTI
Other - Middle Name:M
Other - Last Name:PHADKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 N WOLFE ST
Mailing Address - Street 2:JOHNS HOPKINS UNIVERSITY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0001
Mailing Address - Country:US
Mailing Address - Phone:410-614-5637
Mailing Address - Fax:410-955-1030
Practice Address - Street 1:200 N WOLFE ST
Practice Address - Street 2:JOHNS HOPKINS UNIVERSITY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:410-614-5637
Practice Address - Fax:410-955-1030
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060228L174400000X
MDD00639832080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD409943500Medicaid
PA001811657Medicaid
MD409943500Medicaid
PA001811657Medicaid