Provider Demographics
NPI:1720050248
Name:GARIWALA, MONISH B (MD)
Entity type:Individual
Prefix:DR
First Name:MONISH
Middle Name:B
Last Name:GARIWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 OSLER DR STE 204
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7737
Mailing Address - Country:US
Mailing Address - Phone:443-519-5353
Mailing Address - Fax:443-519-5317
Practice Address - Street 1:7505 OSLER DR STE 204
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7737
Practice Address - Country:US
Practice Address - Phone:443-519-5353
Practice Address - Fax:443-519-5317
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061424174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI10270Medicare UPIN