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Individual

RAMACHANDRA R TATA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
255 HOSPITAL DR STE 208, GLEN BURNIE, MD 21061-5801
(410) 553-8160
(410) 553-8159
Mailing address
255 HOSPITAL DR STE 208, GLEN BURNIE, MD 21061-5801
(410) 553-8160
(410) 553-8159

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
D0092897
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016988180003
PA
05
0016988180007
PA
01
551704
BCBS PA
PA
Enumeration date
11/29/2005
Last updated
03/21/2022
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