Individual
DR. SEJAL G MATTU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
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
D0052139
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
BCBS
—
01
—
201233200
FEDERAL WORKMANS COMP
—
01
—
2167135
AETNA HMO
—
01
—
282075
MAMSI
—
01
—
32483
KAISER
—
01
—
5504586
AETNA PPO
—
01
—
74841805
BCBS
—
05
—
942161102
—
MD
Enumeration date
08/30/2005
Last updated
04/26/2024
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