Individual
DR. SHAMA RAVI MITTAL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14816 PHYSICIANS LN, SUITE 152, ROCKVILLE, MD 20850-3944
(240) 453-0000
(301) 591-4407
Mailing address
14816 PHYSICIANS LN, SUITE 152, ROCKVILLE, MD 20850-3944
(240) 453-0000
(301) 591-4407
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D061382
MD
208000000X
Pediatrics Physician
Primary
D061382
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002542700
—
MD
Enumeration date
07/19/2005
Last updated
09/11/2025
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