Organization
SUPRIYA JAGANNATH MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUPRIYA BANAD JAGANNATH MD (OWNER)
(410) 476-7511
Entity
Organization
Contact information
Practice address
9657 ATTERBURY LN, FREDERICK, MD 21704-7400
(410) 476-7511
Mailing address
9657 ATTERBURY LN, FREDERICK, MD 21704-7400
(410) 476-7511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0064112
MD
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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