Individual
KANCHANA GATTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, S11C, BALTIMORE, MD 21201-1544
(410) 328-6331
(410) 328-1674
Mailing address
PO BOX 64374, BALTIMORE, MD 21264-4374
(410) 328-6331
(410) 328-1674
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
D0066603
MD
207L00000X
Anesthesiology Physician
D0066603
MD
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
D0066603
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413314500
—
MD
01
—
C11298
RAILROAD MEDICARE GROUP #
MD
Enumeration date
05/24/2006
Last updated
10/28/2009
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