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General NPI Number Information
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NPI Number | 1972091585
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Entity Type | Organization
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Legal Business Name | SD CARDIOLOGY ASSOCIATES LLC
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 716 MAIDEN CHOICE LN STE 202
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City | CATONSVILLE
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State | MD
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Zip | 21228-5952
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Country | US
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Telephone | 571-426-1057
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Fax |
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Provider Business Mailing Address
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Address Line | 5010 AMBER MEADOW VIS
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-4893
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Country | US
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Telephone | 571-426-1057
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Fax |
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Authorized Official
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Title or Position | MD; OWNER
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Name | SIRISHA DONEKAL
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Credential | MD
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Telephone | 571-426-1057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | D0069545
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License Number State | MD
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