Provider Demographics
NPI:1194958215
Name:KULMAN, TANZILA SHAMS (MD)
Entity type:Individual
Prefix:
First Name:TANZILA
Middle Name:SHAMS
Last Name:KULMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TANZILA
Other - Middle Name:
Other - Last Name:SHAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6410 ROCKLEDGE DR STE 610
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1844
Mailing Address - Country:US
Mailing Address - Phone:301-530-9743
Mailing Address - Fax:
Practice Address - Street 1:6410 ROCKLEDGE DR STE 610
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1844
Practice Address - Country:US
Practice Address - Phone:301-530-9743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN589292084N0400X
OH35.1221262084N0400X
TXQ28522084N0400X
MDD00898012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC027432315Medicaid
MD208061300Medicaid