Individual provider · NPI-1

Souvonik Adhya, MD

Family Medicine · Glen Burnie, MD

NPI number1114541448
StatusActive
Last updated in NPPESSep 11, 2023

Details

NPI
1114541448
Entity type
Individual (NPI-1)
Name
Souvonik Adhya
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 2, 2020
Certification date
Sep 11, 2023
Last updated
Sep 11, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineD98133MDYes

Practice location

203 Hospital Dr Ste 200
Glen Burnie, MD 21061-6905

Phone 410-553-8362

Mailing address

900 Elkridge Landing Rd Fl 2
Linthicum, MD 21090-2924

Phone 443-462-5010

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