Provider Demographics
NPI:1336450253
Name:GUMA, SHANNAROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANNAROSE
Middle Name:
Last Name:GUMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHANNAROSE
Other - Middle Name:
Other - Last Name:NIGRELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1001 PINE HEIGHTS AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5208
Mailing Address - Country:US
Mailing Address - Phone:410-369-2000
Mailing Address - Fax:410-369-2008
Practice Address - Street 1:1001 PINE HEIGHTS AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5208
Practice Address - Country:US
Practice Address - Phone:410-369-2000
Practice Address - Fax:410-369-2008
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0074300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine