Individual
DR. KRISHAN MATHUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3500 OLD WASHINGTON RD, SUITE 102, WALDORF, MD 20602-3224
(301) 645-4242
(301) 705-7512
Mailing address
PO BOX 2729, LA PLATA, MD 20646-2729
(301) 645-4242
(301) 705-7512
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
D28352
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301331600
—
MD
01
—
35150501
CAREFIRST BC BS
—
01
—
3600310
UHC
—
01
—
38917
MAMSI
—
01
—
4376960
AETNA
—
Enumeration date
06/15/2006
Last updated
11/30/2010
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