Basic Information
Provider Information
NPI: 1437738838
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADNANI
FirstName: HARSHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2003 MEDICAL PKWY STE 350
Address2:  
City: ANNAPOLIS
State: MD
PostalCode: 214013081
CountryCode: US
TelephoneNumber: 4434811091
FaxNumber: 4439497380
Practice Location
Address1: 2001 MEDICAL PKWY
Address2:  
City: ANNAPOLIS
State: MD
PostalCode: 214013773
CountryCode: US
TelephoneNumber: 4434811091
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/05/2021
LastUpdateDate: 04/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X MDY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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