Individual
CHACKMUKAL V CYRIAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8021 RITCHIE HWY, PASADENA, MD 21122-1016
(410) 761-8200
(410) 761-1331
Mailing address
8021 RITCHIE HWY, PASADENA, MD 21122-1016
(410) 761-8200
(410) 761-1331
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D21684
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03152154647401
UNITED HEALTHCARE
—
01
—
110203468
RAILROAD MEDICARE
—
01
—
30837006
BLUESHIELD OF MARYLAND
MD
05
—
775611900
—
MD
Enumeration date
08/05/2006
Last updated
07/08/2007
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