Individual
DR. KOMAL PATIL-SISODIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 706-6474
(410) 706-0231
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4443
(410) 706-6474
(410) 706-0231
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
D70322
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
444103600
—
MD
01
—
975348-01 & 02
CAREFIRST BC/BS
MD
01
—
S062-0447
CAREFIRST BC/BS REGIONAL
MD
Enumeration date
12/17/2008
Last updated
11/10/2011
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