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General NPI Number Information
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NPI Number | 1649428897
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Entity Type | Individual
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Provider Name | UTPAL KANTI DUTTA MD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2008
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 130 HOSPITAL RD STE 300
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-4057
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Country | US
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Telephone | 410-535-4333
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Fax | 410-535-3260
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Provider Business Mailing Address
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Address Line | PO BOX 2424
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City | PRINCE FREDERICK
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State | MD
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Zip | 20678-2424
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Country | US
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Telephone | 410-535-2085
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Fax | 410-535-0404
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | D70833
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License Number State | MD
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