Provider Demographics
NPI:1912176702
Name:UBEROI, JAYANT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYANT
Middle Name:
Last Name:UBEROI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5421
Mailing Address - Country:US
Mailing Address - Phone:443-738-2872
Mailing Address - Fax:
Practice Address - Street 1:6820 HOSPITAL DR
Practice Address - Street 2:SUITE 210
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-4352
Practice Address - Country:US
Practice Address - Phone:410-391-6131
Practice Address - Fax:410-391-6144
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218967208800000X
MDD0068682208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD022127900Medicaid
MD022127900Medicaid