Healthcare Provider Details

I. General information

NPI: 1255589594
Provider Name (Legal Business Name): NISHA ABRAHAM PARAMBIL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7556 TEAGUE RD STE 210
HANOVER MD
21076-1941
US

IV. Provider business mailing address

7580 BUCKINGHAM BLVD STE 220
HANOVER MD
21076-3210
US

V. Phone/Fax

Practice location:
  • Phone: 410-729-3360
  • Fax:
Mailing address:
  • Phone: 410-729-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberD0072973
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: