Provider Demographics
NPI:1881797892
Name:SHERE-WOLFE, KALPANA (MD)
Entity type:Individual
Prefix:
First Name:KALPANA
Middle Name:
Last Name:SHERE-WOLFE
Suffix:
Gender:F
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:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-328-9103
Mailing Address - Fax:410-328-4430
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-9103
Practice Address - Fax:410-328-4430
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD61838207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1881797892Medicaid
DC087267300Medicaid
MD002762600Medicaid
MDP00678060Medicare PIN
G66138Medicare UPIN
MD002762600Medicaid
MD140413Y2ZMedicare PIN