MEDICARE: MANASH KANTI DAS 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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	D68964	MD
2	174400000X	Specialist	21244	MD
3	207R00000X	Internal Medicine Physician	D68964	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D0068964	OTHER	MD	DHMH

General Provider Information

NPI Number	:	1942467071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANASH KANTI DAS M.D.

Provider Business Mailing Address
First Line	:	7582 ANNAPOLIS RD
Second Line	:
City	:	LANDOVER HILLS
State	:	MD
Zip	:	20784-1744
Country	:	US
Telephone Number	:	301-322-2326
Fax Number	:

Provider Business Practice Location Address
First Line	:	7582 ANNAPOLIS RD
Second Line	:
City	:	LANDOVER HILLS
State	:	MD
Zip	:	20784-1744
Country	:	US
Telephone Number	:	301-322-2326
Fax Number	:

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

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	07/21/2020

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