Individual
KALA VISVANATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.B.B.S.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-8964
Mailing address
PO BOX 64474, BALTIMORE, MD 21264-4474
(410) 502-7082
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
D60613
MD
207RX0202X
Medical Oncology Physician
Primary
D60613
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403092300
—
MD
Enumeration date
06/18/2006
Last updated
02/20/2013
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