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NPI Code Detail

MEDICARE: DR. JITENDRAKUMAR RAJNIKANT MODI M.D.

MEDICARE: DR. JITENDRAKUMAR RAJNIKANT MODI 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
1208000000XPediatrics PhysicianD64213MD

General Provider Information

NPI Number : 1629077847
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JITENDRAKUMAR RAJNIKANT MODI M.D.
Provider Business Mailing Address
First Line : 250 WOOD RD
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21402-1257
Country : US
Telephone Number : 410-293-2273
Fax Number : 410-293-3264
Provider Business Practice Location Address
First Line : 250 WOOD RD
Second Line : NHCL ANNAPOLIS (PEDIATRICS)
City : ANNAPOLIS
State : MD
Zip : 21402-1257
Country : US
Telephone Number : 410-293-4414
Fax Number : 410-293-3264
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 12/09/2010

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