Provider Demographics
NPI:1790914273
Name:SHRESTHA, AJIT (MD)
Entity Type:Individual
Prefix:
First Name:AJIT
Middle Name:
Last Name:SHRESTHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:100 E CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5422
Mailing Address - Country:US
Mailing Address - Phone:410-543-7531
Mailing Address - Fax:410-912-4972
Practice Address - Street 1:264 TILGHMAN RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1921
Practice Address - Country:US
Practice Address - Phone:410-742-7246
Practice Address - Fax:410-912-3610
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301092761207L00000X
DEC1-0010385208VP0014X
MDD0078033208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE296049YBAZMedicare PIN