1811082548 NPI number — DR. TEJASHRI S. PUROHIT-SHETH M.D.

Table of content: DR. TEJASHRI S. PUROHIT-SHETH M.D. (NPI 1811082548)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811082548 NPI number — DR. TEJASHRI S. PUROHIT-SHETH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PUROHIT-SHETH
Provider First Name:
TEJASHRI
Provider Middle Name:
S.
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:
PUROHIT
Provider Other First Name:
TEJASHRI
Provider Other Middle Name:
S.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1811082548
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19824 TANBARK WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRINKLOW
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20862-9700
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-774-8338
Provider Business Mailing Address Fax Number:
301-774-8338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8901 WISCONSIN AVENUE
Provider Second Line Business Practice Location Address:
NNMC, BUILDING 9, ALLERGY/IMM. CLINIC
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20889-5600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-295-2510
Provider Business Practice Location Address Fax Number:
301-319-8299
Provider Enumeration Date:
10/04/2006

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: 207K00000X , with the licence number:  0101053658 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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