Individual
DR. SRIRUPA GHOSHTAGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8450 DORSEY RUN RD, JESSUP, MD 20794-9486
(410) 724-3089
Mailing address
5005 RUSHLIGHT PATH, COLUMBIA, MD 21044-1298
(410) 715-4961
(410) 715-4961
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
D0026222
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269341100
—
MD
Enumeration date
10/04/2005
Last updated
06/18/2012
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