Provider Demographics
NPI:1467660274
Name:SHENAI, MAHESH BHASKAR (MD)
Entity Type:Individual
Prefix:
First Name:MAHESH
Middle Name:BHASKAR
Last Name:SHENAI
Suffix:
Gender:M
Credentials:MD
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 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:8081 INNOVATION PARK DR STE 900
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4867
Practice Address - Country:US
Practice Address - Phone:571-472-4100
Practice Address - Fax:571-472-4101
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27856207T00000X
VA0101254011207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051119485OtherBCBS
AL130631Medicaid
AL130634Medicaid
ALZ19096OtherVIVA
AL130632Medicaid
AL051119482OtherBCBS
AL051119484OtherBCBS
AL051119483OtherBCBS
MS05101013Medicaid
AL130696Medicaid
AL051119482OtherBCBS