Healthcare Provider Details

I. General information

NPI: 1194413955
Provider Name (Legal Business Name): PRAJJWAL KUNWAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 MEDICAL PARKWAY SUITE 35
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

2003 MEDICAL PARKWAY SUITE 350
ANNAPOLIS MD
21401
US

V. Phone/Fax

Practice location:
  • Phone: 443-951-4286
  • Fax: 443-949-7380
Mailing address:
  • Phone: 443-951-4286
  • Fax: 443-949-7380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0105880
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: