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Individual

DR. CHETAN BETTEGOWDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD,PHD

Contact information

Practice address
600 N WOLFE ST, PHIPPS 116, BALTIMORE, MD 21287-0005
(410) 955-8620
Mailing address
PO BOX 64286, BALTIMORE, MD 21264-4686
(410) 955-6406

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
D74560
MD
207T00000X
Neurological Surgery Physician
P19991
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
055906700
MD
Enumeration date
01/18/2007
Last updated
05/27/2020
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