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General NPI Number Information
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NPI Number | 1417985854
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Entity Type | Individual
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Provider Name | SRILATHA KANUMURU M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 219 S WASHINGTON ST
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City | EASTON
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State | MD
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Zip | 21601-2913
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Country | US
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Telephone | 410-336-0124
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Fax |
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Provider Business Mailing Address
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Address Line | 5354 AMBROSIA DR
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6862
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0064539
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License Number State | MD
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