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Individual

MANASA SRIVILLIBHUTHUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5200 EASTERN AVE RM 260, BALTIMORE, MD 21224-2734
(410) 550-5018
(410) 550-2972
Mailing address
5200 EASTERN AVE RM 260, BALTIMORE, MD 21224-2734
(410) 550-5018
(410) 550-2972

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
D0100300
MD
390200000X
Student in an Organized Health Care Education/Training Program
05310
RI

Other

Enumeration date
05/15/2021
Last updated
06/27/2024
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