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General NPI Number Information
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NPI Number | 1285837237
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Entity Type | Individual
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Provider Name | KAVITHA KONDURU MD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 1235 E MONUMENT ST
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City | BALTIMORE
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State | MD
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Zip | 21202-5327
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Country | US
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Telephone | 410-327-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 5010 YORK RD
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City | BALTIMORE
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State | MD
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Zip | 21212-4444
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Country | US
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Telephone | 410-443-2200
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Fax |
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | D0069753
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D0069753
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License Number State | MD
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