Healthcare Provider Details

I. General information

NPI: 1659695187
Provider Name (Legal Business Name): KARISHMA ANIK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26005 RIDGE RD SUITE 200
DAMASCUS MD
20872-1892
US

IV. Provider business mailing address

26005 RIDGE RD SUITE 200
DAMASCUS MD
20872-1892
US

V. Phone/Fax

Practice location:
  • Phone: 301-414-2300
  • Fax: 301-414-2306
Mailing address:
  • Phone: 301-414-2300
  • Fax: 301-414-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberH0081952
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: