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Organization
SHASHANK C. SRIVASTAVA, DPM, LLC
Active
Organization
SHASHANK C. SRIVASTAVA, DPM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHASHANK CHANDRA SRIVASTAVA D.P.M. (ONWER/PRESIDENT)
(301) 330-0468
Entity
Organization
Contact information
Practice address
2401 RESEARCH BLVD, SUITE 350, ROCKVILLE, MD 20850-3215
(301) 330-0468
(301) 330-3489
Mailing address
2401 RESEARCH BLVD, SUITE 350, ROCKVILLE, MD 20850-3215
(301) 330-0468
(301) 330-3489
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01392
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019525100
DME - MEDICAID
MD
01
—
1366408221
INDIVIDUAL NPI
MD
05
—
406228100
—
MD
Enumeration date
08/31/2007
Last updated
09/19/2019
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