Individual
SRIVIDYA SATHIYAMOORTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-1180
Mailing address
PO BOX 64478, BALTIMORE, MD 21264-4478
(410) 955-1180
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
D74187
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055642400
—
MD
Enumeration date
02/04/2009
Last updated
03/01/2013
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