MEDICARE: MANISHA J JARIWALA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D0057999	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730174020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANISHA J JARIWALA MD

Provider Business Mailing Address
First Line	:	13950 BRANDYWINE RD
Second Line	:	SUITE 125
City	:	BRANDYWINE
State	:	MD
Zip	:	20613-5815
Country	:	US
Telephone Number	:	301-782-2220
Fax Number	:	301-782-2221

Provider Business Practice Location Address
First Line	:	6710 OXON HILL RD STE 200B
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-1124
Country	:	US
Telephone Number	:	301-373-7900
Fax Number	:	301-373-6900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	06/08/2022

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