Healthcare Provider Details

I. General information

NPI: 1679268221
Provider Name (Legal Business Name): AABHA SHAKYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 THOMAS JOHNSON DR
FREDERICK MD
21702-4679
US

IV. Provider business mailing address

1 FREDERICK HEALTH WAY
FREDERICK MD
21701-9435
US

V. Phone/Fax

Practice location:
  • Phone: 240-215-6310
  • Fax: 240-566-7754
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0107139
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: