Individual
REVATHI VIKRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17050 CATALPA CT, DERWOOD, MD 20855-2576
(240) 912-7185
Mailing address
17050 CATALPA CT, DERWOOD, MD 20855-2576
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0023359
MD
Other
Enumeration date
12/31/2015
Last updated
12/31/2015
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