Healthcare Provider Details

I. General information

NPI: 1821529264
Provider Name (Legal Business Name): KARTHYA POTTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 ANNAPOLIS RD STE 310
ODENTON MD
21113-1744
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-874-1400
  • Fax:
Mailing address:
  • Phone: 410-933-0000
  • Fax: 410-500-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD470811
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0095091
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: