Healthcare Provider Details

I. General information

NPI: 1245222082
Provider Name (Legal Business Name): SIMITA U. TALWAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SIMITA B. DAS M.D.

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 02/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 CRONSON BLVD SUITE E
CROFTON MD
21114-2064
US

IV. Provider business mailing address

1302 CRONSON BLVD SUITE E
CROFTON MD
21114-2064
US

V. Phone/Fax

Practice location:
  • Phone: 410-451-1301
  • Fax: 410-451-1037
Mailing address:
  • Phone: 410-451-1301
  • Fax: 410-451-1037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0060832
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: