Provider Demographics
NPI:1639377682
Name:AIKARA, TESSIE GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:TESSIE
Middle Name:GEORGE
Last Name:AIKARA
Suffix:
Gender:F
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 759047
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-9047
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:
Practice Address - Street 1:10424 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2321
Practice Address - Country:US
Practice Address - Phone:240-542-5987
Practice Address - Fax:240-542-5988
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD77904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD519295YVZMedicare PIN
MD519295ZDDBMedicare PIN
MD134835YWV2Medicare PIN