Healthcare Provider Details

I. General information

NPI: 1487632600
Provider Name (Legal Business Name): MONIKA DHILLON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N CALVERT ST SUITE 585
BALTIMORE MD
21218-2867
US

IV. Provider business mailing address

21 BRETT MANOR CT
HUNT VALLEY MD
21030-1228
US

V. Phone/Fax

Practice location:
  • Phone: 410-261-8532
  • Fax: 410-261-8055
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberD0063540
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: