Individual
SUMESKA THAVARAJAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0979
Mailing address
PO BOX 64264, BALTIMORE, MD 21264-4264
(410) 550-0979
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D63421
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408418700
—
MD
Enumeration date
07/05/2006
Last updated
02/19/2013
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