Jagannath, Supriya Banad
Jagannath, Supriya Banad is an individual health care provider with primary practice located at 100 E Carroll St , Salisbury MD 21801-5422. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Jagannath, Supriya Banad can be contacted via phone (410) 543-7375.Contact Information
Primary practice address
100 E Carroll St
Salisbury MD 21801-5422
Phone: (410) 543-7375
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | D0064112 | Maryland |
Profile Details
| NPI number | 1164464434 |
|---|---|
| LBN Legal business name | Jagannath, Supriya Banad |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Nov 11th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164464434 | NPPES |
| Maryland | MEDICAID | 411276800 |
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