Individual
MANJIT KAUR RISAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3060 MITCHELLVILLE RD, 210, BOWIE, MD 20716-1389
(301) 249-4090
(301) 390-1344
Mailing address
8110 MAPLE LAWN BLVD STE 235, FULTON, MD 20759-2694
(301) 340-8339
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
D0032735
MD
207VG0400X
Gynecology Physician
Primary
D0032735
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04830
AMERIGROUP ID#
—
01
—
0700031
UNITEDHEALTHCARE ID #
—
01
—
203249
HEALTHKEEPERS ID#
VA
01
—
27866
JOHN HOPKINS EHP ID #
MD
05
—
405671000
—
MD
01
—
4089037
AETNA PROVIDER #
—
01
—
41985902
CAREFIRST MD ID #
MD
01
—
46565
MAMSI ID#
—
01
—
495982
NCPPO ID #
—
01
—
521854007
ALL OTHER INS CO. ID #
MD
01
—
56760001
CAREFIRST DC
DC
Enumeration date
09/08/2005
Last updated
11/29/2023
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