Individual
MAYURIKA GHOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-2463
(410) 328-4430
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-2463
(410) 328-4430
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
D61121
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407044500
—
MD
01
—
642473-01
BC/BS
MD
01
—
S062-0319
BC/BS REGIONAL
MD
Enumeration date
12/12/2005
Last updated
05/16/2012
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