Healthcare Provider Details

I. General information

NPI: 1346291051
Provider Name (Legal Business Name): SMITHA BHIKKAJI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1483
US

IV. Provider business mailing address

PO BOX 83819
GAITHERSBURG MD
20883-3819
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-7991
  • Fax: 301-754-7990
Mailing address:
  • Phone: 301-754-7991
  • Fax: 301-754-7990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0064100
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD64100
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: