Individual
SHALINI KOPPISETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3001 HOSPITAL DR FL 5, CHEVERLY, MD 20785-1189
(301) 618-3772
(301) 618-2986
Mailing address
3001 HOSPITAL DR FL 5, CHEVERLY, MD 20785-1189
(301) 618-3772
(301) 618-2986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301504842
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2018
Last updated
08/03/2021
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