Healthcare Provider Details

I. General information

NPI: 1477464188
Provider Name (Legal Business Name): SHREE NIKHITA KAMBHAMPATI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E UNIVERSITY PKWY
BALTIMORE MD
21218-2829
US

IV. Provider business mailing address

3062 TERRA MARIA WAY
ELLICOTT CITY MD
21042-2700
US

V. Phone/Fax

Practice location:
  • Phone: 410-554-2000
  • Fax:
Mailing address:
  • Phone: 410-294-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31210
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: