Individual
POONAM MATHUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 225-8369
(410) 552-2685
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-8040
(443) 462-3514
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
H3904
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
542207800
—
MD
Enumeration date
05/13/2011
Last updated
07/21/2022
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