# FAMILY MEDICINE SHADY GROVE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Medicine Shady Grove, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588093371
- **Authorized official:** DR. MANISHA KALRA M.D. (PHYSICIAN)
- **Authorized official phone:** (301) 284-8990

## Contact information

- **Practice address:** 15215 SHADY GROVE RD STE 304, ROCKVILLE, MD 20850-0200
- **Practice address phone:** (301) 284-8990
- **Practice address fax:** (301) 569-4293
- **Mailing address:** 15215 SHADY GROVE RD STE 304, ROCKVILLE, MD 20850-0200
- **Mailing address phone:** (301) 284-8990
- **Mailing address fax:** (301) 569-4293

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | D0073851 | MD | Yes |

## Other

- **Enumeration date:** 11/02/2013
- **Last updated:** 04/21/2014