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General NPI Number Information
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NPI Number | 1952310880
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Entity Type | Organization
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Legal Business Name | RITA MATHUR
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9106 PHILADELPHIA RD STE 200
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City | BALTIMORE
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State | MD
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Zip | 21237-4329
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Country | US
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Telephone | 410-780-1980
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Fax | 410-780-1984
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Provider Business Mailing Address
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Address Line | PO BOX 1094
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City | BEL AIR
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State | MD
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Zip | 21014-7094
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Country | US
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Telephone | 410-780-1980
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Fax | 410-780-1984
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | GEETA N ESAU
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Credential |
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Telephone | 410-780-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0057021
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License Number State | MD
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