Individual
SUJATHA KANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1800 ORLEANS ST, BLOOMBERG CC 6321, BALTIMORE, MD 21287-0010
(410) 955-6412
Mailing address
PO BOX 64382, BALTIMORE, MD 21264-4382
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301072890
MI
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
D72754
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046493700
—
MD
Enumeration date
06/02/2006
Last updated
05/13/2013
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