MUKTA MEDICAL INC NPI 1194197152

NPI Information

  • NPI: 1194197152
  • Provider Name: MUKTA MEDICAL INC
  • Classification: Internal Medicine - 207RI0200X
  • Specialization: Infectious Disease
  • Entity Type: Organization
  • Address: 5415 OLD COURT RD
    SUITE 101
    RANDALLSTOWN, MD
    ZIP 21133
  • Phone: (410) 922-2650

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NPI Details

MUKTA MEDICAL INC is an infectious disease internal medicine in Randallstown, MD. The provider is an internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. MUKTA MEDICAL INC NPI is 1194197152. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5415 OLD COURT RD
SUITE 101
RANDALLSTOWN, MD
ZIP 21133-170
Phone: (410) 922-2650
Fax: (410) 922-1612

The provider's authorized official is Mohammed Kiddugavu .
The authorized official title is Owner and has the following contact phone number (410) 922-2650.

The enumeration date for this NPI number is 10/29/2015 and was last updated on 9/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RI0200XInternal MedicineInfectious DiseaseD0070832MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1901901400MEDICAIDMARYLAND
2450901MEDICARE PINMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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