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General NPI Number Information
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NPI Number | 1750649984
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Entity Type | Individual
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Provider Name | REKHA MADHAVI MATTAPARTHI RPH
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Gender | Female
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 1321 RIVERSIDE PKWY
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City | BELCAMP
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State | MD
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Zip | 21017-1388
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Country | US
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Telephone | 410-272-8741
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Fax |
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Provider Business Mailing Address
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Address Line | 656 CARLETON TRL
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City | BEL AIR
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State | MD
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Zip | 21014-2838
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Country | US
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Telephone | 443-528-7498
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18596
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License Number State | MD
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