1649279787 NPI number — DR. SHIVANI JINDAL NARASIMHAN M.D.

Table of content: MARY FROST (NPI 1043017379)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649279787 NPI number — DR. SHIVANI JINDAL NARASIMHAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NARASIMHAN
Provider First Name:
SHIVANI
Provider Middle Name:
JINDAL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JINDAL
Provider Other First Name:
SHIVANI
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1649279787
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
849 FAIRMOUNT AVE STE 100B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOWSON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21286-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-235-1168
Provider Business Mailing Address Fax Number:
813-291-7502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
849 FAIRMOUNT AVE STE 100B
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21286-2600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-235-1168
Provider Business Practice Location Address Fax Number:
813-291-7502
Provider Enumeration Date:
07/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  D60351 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 120789 . This is a "JHHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61981605 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61981604 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61981601 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3107908 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3193554 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61981603 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7618430 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6105 . This is a "BRAVO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61981602 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0002 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61981606 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".




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