Healthcare Provider Details

I. General information

NPI: 1972649531
Provider Name (Legal Business Name): UMASUTHAN SRIKUMARAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 CHARTER DR SUITE 140
COLUMBIA MD
21044-3629
US

IV. Provider business mailing address

PO BOX 64664
BALTIMORE MD
21264-4664
US

V. Phone/Fax

Practice location:
  • Phone: 443-546-1550
  • Fax: 443-546-1551
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberP20257
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD72309
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: