Individual
DR. JYOTHI RACHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4100 COLLEGE AVE, ELLICOTT CITY, MD 21043-5506
(443) 364-5500
(443) 364-5501
Mailing address
4100 COLLEGE AVE, ELLICOTT CITY, MD 21043-5506
(443) 364-5500
(443) 364-5501
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0062956
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
409207400
—
MD
Enumeration date
10/27/2006
Last updated
02/03/2014
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