Mittal, Shama Ravi
Mittal, Shama Ravi is an individual health care provider with primary practice located at 14816 Physicians Ln Suite 152, Rockville MD 20850-3944. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Mittal, Shama Ravi can be contacted via phone (240) 453-0000.Contact Information
Primary practice address
14816 Physicians Ln Suite 152
Rockville MD 20850-3944
Phone: (240) 453-0000
Fax: (301) 591-4407
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | D061382 | Maryland |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | D061382 | Maryland |
Profile Details
| NPI number | 1508865973 |
|---|---|
| LBN Legal business name | Mittal, Shama Ravi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2005 |
| Last updated | Jul 13th, 2026 - about 4 months 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 | 1508865973 | NPPES |
| Maryland | MEDICAID | 002542700 |
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