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Organization
SKANUMURU, LLC
Active
Organization
SKANUMURU, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRILATHA KANUMURU M.D. (OWNER)
(410) 719-0020
Entity
Organization
Contact information
Practice address
1406 CRAIN HWY S, SUITE 108, GLEN BURNIE, MD 21061-4058
(410) 760-0098
(410) 761-9131
Mailing address
5354 AMBROSIA DR, ELLICOTT CITY, MD 21043-6862
(410) 336-0124
(410) 744-6755
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
D0064539
MD
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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