Organization
RIVERSIDE PRIMARY CARE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADHU MOHAN KATIKINENI M.D. (PRESIDENT)
(301) 927-7750
Entity
Organization
Contact information
Practice address
6400 MARLBORO PIKE, DISTRICT HEIGHTS, MD 20747-2841
(301) 736-7000
(301) 736-6916
Mailing address
6510 KENILWORTH AVE, SUITE 1400, RIVERDALE, MD 20737-1339
(301) 927-2683
(301) 779-8243
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
749501310
—
MD
Enumeration date
05/22/2006
Last updated
03/05/2015
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