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Individual

DR. RITA DELORES WUTOH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7800 CENTRAL AVE, HYATTSVILLE, MD 20785-4807
(410) 804-7200
(301) 218-7916
Mailing address
7800 CENTRAL AVE, HYATTSVILLE, MD 20785-4807
(410) 804-7200
(301) 218-7916

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0053915
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101895
JHHC PROVIDER NUMBER
MD
01
1167557
CIGNA PIN
MD
01
2163607
MAMSI SPECIALIST
MD
05
332502400
MD
01
3654331
AETNA CAPITATED
MD
05
521923448
MD
01
5317701
AETNA FEE FOR SERVICE
MD
01
642957-03
CAREFIRST MD RENDERING
MD
01
7605-0081
CAREFIRST BLUECHOICE
MD
01
8163607
MAMSI PRIMARY CARE
MD
01
P00381804
RAILROAD MEDICARE
MD
01
P17049
CAREFIRST MPOS
MD
Enumeration date
08/25/2005
Last updated
12/28/2020
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