Provider Demographics
NPI:1912340068
Name:NAYAK, SHRIDDHA (MD)
Entity type:Individual
Prefix:
First Name:SHRIDDHA
Middle Name:
Last Name:NAYAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:PHIPPS 228
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-1228
Mailing Address - Country:US
Mailing Address - Phone:410-955-8487
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:PHIPPS 228
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-1228
Practice Address - Country:US
Practice Address - Phone:410-955-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD83913207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology