Provider Demographics
NPI:1336532993
Name:GARG, GAURANG KRISHAN (MD)
Entity Type:Individual
Prefix:
First Name:GAURANG
Middle Name:KRISHAN
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10755 FALLS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4520
Mailing Address - Country:US
Mailing Address - Phone:410-583-7144
Mailing Address - Fax:410-583-7145
Practice Address - Street 1:10755 FALLS RD STE 200
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4520
Practice Address - Country:US
Practice Address - Phone:410-583-7144
Practice Address - Fax:410-583-7145
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0094151207R00000X
IL036155818208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty