Individual
RAJU DATLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14920 OLD COLUMBIA PIKE, BURTONSVILLE, MD 20866-1610
(240) 305-3484
(301) 476-7544
Mailing address
14920 OLD COLUMBIA PIKE, BURTONSVILLE, MD 20866-1610
(240) 305-3484
(301) 476-7544
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/05/2021
Last updated
11/05/2021
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