Provider Demographics
NPI:1487648424
Name:PARSHAD, ADITYA (MD)
Entity Type:Individual
Prefix:
First Name:ADITYA
Middle Name:
Last Name:PARSHAD
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 1:331 OAK MANOR DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5508
Mailing Address - Country:US
Mailing Address - Phone:410-760-6666
Mailing Address - Fax:410-760-2066
Practice Address - Street 1:331 OAK MANOR DR
Practice Address - Street 2:SUITE 202
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5508
Practice Address - Country:US
Practice Address - Phone:410-760-6666
Practice Address - Fax:410-760-2066
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2013-02-27
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
MDD0045354207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD262539OtherPTAN: GROUP 262534 GROUP MEMBER:262539YL3Z
MD212304500Medicaid
MDG12470Medicare UPIN