Individual
DR. NAYANTARA MENDONCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
985 PRINCE FREDERICK BLVD STE 201, PRINCE FREDERICK, MD 20678-3492
(410) 535-2005
(410) 535-4850
Mailing address
985 PRINCE FREDERICK BLVD STE 201, PRINCE FREDERICK, MD 20678-4020
(410) 535-2005
(410) 535-4850
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0060638
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2129823
MAMSI HMO
MD
01
—
3640951
AETNA HMO
MD
05
—
402561000
—
MD
01
—
62544302
CAREFIRST OF MARYLAND
MD
01
—
7411517
AETNA NON-HMO
MD
01
—
C0410033
CAREFIRST OF DC
DC
01
—
P00256094
RAILROAD MEDICARE
MD
Enumeration date
01/17/2007
Last updated
04/17/2018
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