Organization
KATHY MAHALATI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY M MAHALATI MD (OWNER)
(301) 254-8842
Entity
Organization
Contact information
Practice address
404 FIRESTONE DR, SILVER SPRING, MD 20905-8010
(410) 254-8842
(410) 633-9182
Mailing address
404 FIRESTONE DR, SILVER SPRING, MD 20905-8010
(410) 254-8842
(410) 633-9198
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0054561
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
917900300
—
MD
Enumeration date
02/22/2011
Last updated
02/22/2011
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