Individual
UTPAL KANTI DUTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 HOSPITAL RD STE 300, PRINCE FREDERICK, MD 20678-4057
(410) 535-4333
(410) 535-3260
Mailing address
PO BOX 2424, PRINCE FREDERICK, MD 20678-2424
(410) 535-2085
(410) 535-0404
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D70833
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01366238
AMERIGROUP
—
01
—
1649428897
TRICARE
—
05
—
418952301
—
MD
01
—
522300606
PATUXENT NEPHROLOGY ASSOCIATES, LLC
MD
01
—
F117 AND 0J48PA
CAREFIRST BLUECROSS BLUESHIELD
—
Enumeration date
08/29/2008
Last updated
12/06/2021
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