Provider Demographics
NPI:1225078678
Name:KHANNA, NIHARIKA (MBBS, MD, DGO)
Entity Type:Individual
Prefix:DR
First Name:NIHARIKA
Middle Name:
Last Name:KHANNA
Suffix:
Gender:F
Credentials:MBBS, MD, DGO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64380
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4380
Mailing Address - Country:US
Mailing Address - Phone:410-328-6792
Mailing Address - Fax:410-328-8726
Practice Address - Street 1:29 S PACA ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1771
Practice Address - Country:US
Practice Address - Phone:667-214-1896
Practice Address - Fax:410-685-1971
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD82386207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF32166Medicare UPIN