# SKANUMURU, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952540635
- **Authorized official:** DR. SRILATHA KANUMURU M.D. (OWNER)
- **Authorized official phone:** (410) 719-0020

## Contact information

- **Practice address:** 1406 CRAIN HWY S, SUITE 108, GLEN BURNIE, MD 21061-4058
- **Practice address phone:** (410) 760-0098
- **Practice address fax:** (410) 761-9131
- **Mailing address:** 5354 AMBROSIA DR, ELLICOTT CITY, MD 21043-6862
- **Mailing address phone:** (410) 336-0124
- **Mailing address fax:** (410) 744-6755

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | D0064539 | MD | Yes |

## Other

- **Enumeration date:** 02/19/2009
- **Last updated:** 02/19/2009