Organization
SEJAL G. MATTU MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEJAL G MATTU MD (PHYSICIAN OWNER)
(410) 451-7214
Entity
Organization
Contact information
Practice address
2401 BRANDERMILL BLVD, SUITE 220, GAMBRILLS, MD 21054-1690
(410) 451-7214
(410) 451-7218
Mailing address
2401 BRANDERMILL BLVD. SUITE 220, GAMBRILLS, MD 21054-1692
(410) 451-7214
(410) 451-7218
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0M96SG
BCBS
—
01
—
6254
BCBS
—
Enumeration date
01/26/2006
Last updated
04/25/2024
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