Provider Demographics
NPI:1851352538
Name:KINARIWALA, SMRUTI JAYESH (MD)
Entity Type:Individual
Prefix:DR
First Name:SMRUTI
Middle Name:JAYESH
Last Name:KINARIWALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SMRUTI
Other - Middle Name:RANCHHODBHAI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1475 TANEY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-5126
Mailing Address - Country:US
Mailing Address - Phone:301-662-0133
Mailing Address - Fax:301-695-8604
Practice Address - Street 1:1475 TANEY AVE
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4747
Practice Address - Country:US
Practice Address - Phone:301-662-0133
Practice Address - Fax:301-695-8604
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD96795208000000X
FLME142651208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH76944Medicare UPIN