Individual
MARIA THEKKEKANDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 VILLAGE CENTER DR STE 1002, CHAPEL HILL, NC 27516
(984) 215-6550
(984) 215-6555
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 339-5413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
191665
NC
207Q00000X
Family Medicine Physician
MD60658356
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2061905
—
WA
Enumeration date
06/17/2013
Last updated
02/25/2021
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