Individual
DR. ANSU MATHEW PUNNOOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
8175 WESTSIDE BLVD STE D, FULTON, MD 20759-2708
(240) 580-2650
(240) 580-2651
Mailing address
8175 WESTSIDE BLVD STE D, FULTON, MD 20759-2708
(240) 580-2650
(240) 580-2651
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H0079559
MD
Other
Enumeration date
04/13/2012
Last updated
10/09/2023
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