Individual
ANANDITA ASHOKE DATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4801 TESLA DR STE H, BOWIE, MD 20715-4327
(301) 464-0603
Mailing address
4801 TESLA DR STE H, BOWIE, MD 20715-4327
(301) 464-0603
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2005-00431
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D70018
MD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD036064
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132796 - 191662ZAYC
MEDICARE
MD
01
—
5184 - 191662YB84
MEDICARE
MD
01
—
5184GE - 96812201
CAREFIRST
MD
01
—
7592 - 0003
CAREFIRST
DC
01
—
7795VA - 96812202
CAREFIRST
MD
01
—
7797 - 191662YB8
MEDICARE
MD
01
—
F830JM - 96812203
CAREFIRST
MD
01
—
N358 - 0003
CAREFIRST
DC
01
—
W247 - 0003
CAREFIRST
DC
Enumeration date
07/07/2006
Last updated
07/23/2025
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