Provider Demographics
NPI:1649279787
Name:NARASIMHAN, SHIVANI JINDAL (MD)
Entity type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:JINDAL
Last Name:NARASIMHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHIVANI
Other - Middle Name:
Other - Last Name:JINDAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:711 W 40TH ST STE 212A
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2108
Mailing Address - Country:US
Mailing Address - Phone:410-235-1168
Mailing Address - Fax:410-235-1277
Practice Address - Street 1:711 W 40TH ST STE 212A
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2108
Practice Address - Country:US
Practice Address - Phone:410-235-1168
Practice Address - Fax:410-235-1277
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD60351207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
120789OtherJHHC
61981605OtherCAREFIRST
61981604OtherCAREFIRST
61981601OtherCAREFIRST
3107908OtherMAMSI
3193554OtherAETNA HMO
61981603OtherCAREFIRST
7618430OtherAETNA PPO
6105OtherBRAVO
61981602OtherCAREFIRST
0002OtherCAREFIRST
61981606OtherCAREFIRST
61981602OtherCAREFIRST
G262Medicare PIN
0002OtherCAREFIRST
61981602OtherCAREFIRST