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Individual

SHANTHI S THOMAS KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6350 STEVENS FOREST RD STE 103, COLUMBIA, MD 21046-3255
(443) 259-3770
Mailing address
3100 WYMAN PARK DR, BALTIMORE, MD 21211-2803

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0062930
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
408936700
MD
Enumeration date
06/30/2006
Last updated
06/25/2024
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