Provider Demographics
NPI:1720729874
Name:BANDARA, NITIKA BANSAL (MD)
Entity type:Individual
Prefix:
First Name:NITIKA
Middle Name:BANSAL
Last Name:BANDARA
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 1:8600 SNOWDEN RIVER PKWY STE 207
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1985
Mailing Address - Country:US
Mailing Address - Phone:301-515-2901
Mailing Address - Fax:
Practice Address - Street 1:8600 SNOWDEN RIVER PKWY STE 207
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1985
Practice Address - Country:US
Practice Address - Phone:301-515-2901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0103410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine