Provider Demographics
NPI:1902997943
Name:JAISWAL, ARTI (MD)
Entity type:Individual
Prefix:
First Name:ARTI
Middle Name:
Last Name:JAISWAL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ARTI
Other - Middle Name:JAISWAL
Other - Last Name:BALCHANDANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9011 CHEVROLET DR STE 1-6
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4024
Mailing Address - Country:US
Mailing Address - Phone:410-465-7550
Mailing Address - Fax:410-465-6359
Practice Address - Street 1:9011 CHEVROLET DR STE 1-6
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4024
Practice Address - Country:US
Practice Address - Phone:410-465-7550
Practice Address - Fax:410-465-6359
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240935208000000X
MDD0100498208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY02803336Medicaid
NYG100000410Medicare Oscar/Certification
NY331009Medicare Oscar/Certification