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NPI Code Detail

MEDICARE: SHYLAJA UNNIKRISHNA KESHAV MD

MEDICARE: SHYLAJA UNNIKRISHNA KESHAV MD
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
1207Q00000XFamily Medicine PhysicianD57652MD

General Provider Information

NPI Number : 1326031063
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHYLAJA UNNIKRISHNA KESHAV MD
Provider Business Mailing Address
First Line : PO BOX 758963
Second Line :
City : BALTIMORE
State : MD
Zip : 21275-8963
Country : US
Telephone Number : 804-968-5700
Fax Number :
Provider Business Practice Location Address
First Line : 3357B CORRIDOR MARKETPLACE
Second Line :
City : LAUREL
State : MD
Zip : 20724-2381
Country : US
Telephone Number : 301-497-1820
Fax Number : 301-497-5489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2005
Last Update Date : 05/02/2013

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