Individual
PRASHANT ROHIT SHUKLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
998 HOSPITALITY WAY, SUITE 102, BAYSIDE INTERNAL MEDICINE, LLC, ABERDEEN, MD 21001-1757
(410) 297-9500
(410) 297-9016
Mailing address
998 HOSPITALITY WAY, SUITE 102, BAYSIDE INTERNAL MEDICINE, LLC, ABERDEEN, MD 21001-1757
(410) 297-9500
(410) 297-9016
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D48050
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110247432
RAILROAD MEDICARE
GA
01
—
489M734F
MEDICARE
MD
01
—
529802400
MEDICAL ASSISTANCE
MD
01
—
54449804
CAREFIRST
MD
01
—
G738-0001
CAREFIRST
DC
Enumeration date
12/19/2005
Last updated
06/28/2012
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