Healthcare Provider Details

I. General information

NPI: 1063495232
Provider Name (Legal Business Name): KAVITA B KALRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 40TH ST STE 427
BALTIMORE MD
21211-2120
US

IV. Provider business mailing address

711 W 40TH ST STE 427
BALTIMORE MD
21211-2120
US

V. Phone/Fax

Practice location:
  • Phone: 410-246-4450
  • Fax: 410-617-8326
Mailing address:
  • Phone: 410-246-4450
  • Fax: 410-617-8326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD58037
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: