Provider Demographics
NPI:1861420952
Name:INTENSIVE PULMONOLOGY INC.
Entity type:Organization
Organization Name:INTENSIVE PULMONOLOGY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:NATESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANMUGAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-468-3303
Mailing Address - Street 1:12204 SELINE WAY
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2872
Mailing Address - Country:US
Mailing Address - Phone:202-468-3303
Mailing Address - Fax:
Practice Address - Street 1:7500 HANOVER PKWY STE 105B
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2091
Practice Address - Country:US
Practice Address - Phone:301-593-8500
Practice Address - Fax:301-593-7547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050412207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD746801600Medicaid
MDH01760Medicare UPIN