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General NPI Number Information
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NPI Number | 1134120793
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Entity Type | Individual
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Provider Name | RITA KRISHAN DHAWAN MD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 04/18/2018
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Provider Practice Location Address
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Address Line | 8516 TIMBER VALLEY CT
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6065
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Country | US
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Telephone | 410-461-8781
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Fax | 410-461-8781
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Provider Business Mailing Address
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Address Line | 9055 CHEVROLET DRIVE SUITE 103
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City | ELLICOTT CITY
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State | MD
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Zip | 21042
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Country | US
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Telephone | 410-461-8781
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Fax | 410-461-8781
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0062534
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License Number State | MD
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