Individual
DEEPTHI K BOMMADEVARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D; M.P.H
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2950
(443) 444-4362
Mailing address
5601 LOCH RAVEN BLVD, DEPARTMENT OF HOSPITAL MEDICINE, BALTIMORE, MD 21239
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
C1-0009777
DE
207R00000X
Internal Medicine Physician
Primary
D-00082788
MD
Other
Enumeration date
06/17/2008
Last updated
09/09/2024
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