Dr. Shishir K. Khetan MD - Internal Medicine Physician in Rockville, Maryland | ProviderWire

Full Name

Dr. Shishir Kumar Khetan MD

NPI Number

1861497372

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/21/2005

Specialties

(Taxonomies)

Name

Internal Medicine Physician

Code

207R00000X

Primary Taxonomy

Yes

Licenses

State

Connecticut

Florida

Maryland

License Number

73702

ME148198

D0061630

Contact
Information

Purpose

Mailing

Location

Address

PO BOX 79632

1201 SEVEN LOCKS RD

City

Baltimore

Rockville

State

MD

MD

Postal Code

21279-0632

20854-2957

Country

US

US

Telephone Number

(301) 762-5020

(301) 762-5020

Identifiers

Identifier

PENDING

416410500

Identifier State

FL

MD

Identifier Issuer

MEDICARE HF

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/13/2024

Provider Address

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