Individual
UTKALA SEGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18629 AUTUMN MIST DR, GERMANTOWN, MD 20874-2180
(240) 441-8178
Mailing address
18629 AUTUMN MIST DR, GERMANTOWN, MD 20874-2180
(240) 441-8178
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C07275
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/16/2018
Last updated
11/14/2019
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