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General NPI Number Information
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NPI Number | 1245891233
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Entity Type | Individual
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Provider Name | ROMIK PRAKASH SRIVASTAVA MD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 171 ASHLEY AVE
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City | CHARLESTON
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State | SC
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Zip | 29425-8908
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Country | US
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Telephone | 843-792-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | BALTIMORE
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-6423
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL82748
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | D0104137
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License Number State | MD
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