| Beena Khetpal, | |
|
22590 Shady Ct, California, MD 20619-5009 | |
| (301) 373-7900 | |
| (301) 373-6900 |
| Full Name | Beena Khetpal |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 22590 Shady Ct, California, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568497477 | NPI | - | NPPES |
| 175701600 | Medicaid | MD | |
| 370017638 | Other | MD | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | D0055067 (Maryland) | Primary |
| Entity Name | Medstar Medical Group - Southern Maryland Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831592211 PECOS PAC ID: 1355667056 Enrollment ID: O20150223001281 |
| Mailing Address | Practice Location Address |
|---|---|
| Beena Khetpal, 22590 Shady Ct, California, MD 20619-5009 Ph: (301) 373-7900 | Beena Khetpal, 22590 Shady Ct, California, MD 20619-5009 Ph: (301) 373-7900 |
Dr. Viral Dhiraj Gala, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 22590 Shady Court, Mmc, Dept Of Pediatrics,, California, MD 20619 Phone: 301-863-9000 | |
Carmen Fanous, Pediatrics Medicare: Medicare Enrolled Practice Location: 22590 Shady Ct, California, MD 20619 Phone: 301-373-7900 Fax: 301-373-6900 | |
Amit H Sheth, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 22878 Three Notch Rd, California, MD 20619 Phone: 301-863-6373 Fax: 301-863-6313 |