MEDICARE: RITU CHITAKKI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	D0051171	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609823798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITU CHITAKKI M.D.

Provider Business Mailing Address
First Line	:	3450 LAUREL FORT MEADE RD STE 207
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724-2040
Country	:	US
Telephone Number	:	301-490-3088
Fax Number	:	301-490-2575

Provider Business Practice Location Address
First Line	:	3450 LAUREL FORT MEADE RD STE 207
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20724-2040
Country	:	US
Telephone Number	:	301-490-3088
Fax Number	:	301-490-2575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	04/05/2012

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Directions to “ RITU CHITAKKI M.D.” Practice Location

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