Organization
ANUSHA SIRITHARA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANUSHA SIRITHARA MD (OWNER)
(410) 337-6700
Entity
Organization
Contact information
Practice address
260 GATEWAY DR STE 2122B, BEL AIR, MD 21014-4268
(410) 877-2585
(410) 877-2587
Mailing address
260 GATEWAY DR STE 2122B, BEL AIR, MD 21014-4268
(410) 877-2585
(410) 877-2587
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D26191
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-196262020658
AMERIGROUP - AMERICAID
MD
01
—
1962620658
RIVER SIDE HEALTH CARE
MD
01
—
1962620658
CORE SOURCE
—
05
—
1962620658
—
MD
Enumeration date
04/20/2007
Last updated
06/30/2015
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