MEDICARE: DR. HARSHAD R MODY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	D0023632	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316907892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARSHAD R MODY M.D.

Provider Business Mailing Address
First Line	:	7310 RITCHIE HWY
Second Line	:	SUITE 710
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-3065
Country	:	US
Telephone Number	:	410-760-5599
Fax Number	:	410-760-3917

Provider Business Practice Location Address
First Line	:	7310 RITCHIE HWY
Second Line	:	SUITE 710
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-3065
Country	:	US
Telephone Number	:	410-760-5599
Fax Number	:	410-760-3917

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	10/10/2012

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