Individual
RAKESH K MATHUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2112 BEL AIR RD, SUITE 1, FALLSTON, MD 21047
(410) 877-8550
(410) 877-8551
Mailing address
2112 BEL AIR RD, SUITE 1, FALLSTON, MD 21047-2786
(410) 877-8550
(410) 877-8551
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0039170
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279700300
—
MD
Enumeration date
02/17/2006
Last updated
07/29/2013
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