Healthcare Provider Details

I. General information

NPI: 1598010514
Provider Name (Legal Business Name): SIMRAN MALHOTRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 FRANKLIN SQUARE DR DEPT OF INTERNAL MEDICINE
BALTIMORE MD
21237-3901
US

IV. Provider business mailing address

3200 ODONNELL ST
BALTIMORE MD
21224-5038
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-8300
  • Fax: 443-777-8344
Mailing address:
  • Phone: 410-622-6357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberD0079825
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: