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Individual

PANKAJ KHETERPAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
120 EASTERN BLVD, BALTIMORE, MD 21221-7020
(410) 687-8818
(410) 682-3989
Mailing address
20 HICKORY KNOLL CT, TIMONIUM, MD 21093-4745
(410) 687-8818
(410) 682-3989

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0060560
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1026359400001
MEDICAL ASSISTANCE
PA
01
1801813746
BRAVO HEALTH
MD
01
300443355001
HEALTHNET FEDERAL SERVICES - TRICARE
SC
01
402778700
MEDICAL ASSISTANCE
MD
01
618SZBQK
MEDICARE
MD
01
N681-0001
CAREFIRST
DC
01
P00693651
RAILROAD MEDICARE
GA
Enumeration date
07/16/2006
Last updated
06/27/2025
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