Provider Demographics
NPI:1982690715
Name:WALIA, KULBIR (MD)
Entity Type:Individual
Prefix:DR
First Name:KULBIR
Middle Name:
Last Name:WALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK ROAD,
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031
Mailing Address - Country:US
Mailing Address - Phone:410-329-1071
Mailing Address - Fax:410-329-1054
Practice Address - Street 1:160 AVENUE AT THE CMN
Practice Address - Street 2:SUITE 1
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702
Practice Address - Country:US
Practice Address - Phone:732-380-0200
Practice Address - Fax:732-380-0262
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD064924L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH22254Medicare UPIN