Individual
SHAVITRI ANANDA MAHENDIRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, DEPT OF RADIOLOGY, BALTIMORE, MD 21201-1544
(410) 328-3477
Mailing address
22 S GREENE ST, DEPT OF RADIOLOGY, BALTIMORE, MD 21201-1544
(410) 328-3477
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0086858
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069425254
—
DC
05
—
563008800
—
MD
Enumeration date
04/30/2011
Last updated
08/30/2019
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