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NPI Code Detail

MEDICARE: ATCHUTHA GEETHA CHAN CHILAKAMARRI MD

MEDICARE: ATCHUTHA GEETHA CHAN CHILAKAMARRI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianMD037199DC
2207QG0300XGeriatric Medicine (Family Medicine) PhysicianD69568MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750508958
Entity Type Code : Individual
Provider Name (Legal Business Name) : ATCHUTHA GEETHA CHAN CHILAKAMARRI MD
Provider Business Mailing Address
First Line : PO BOX 37086
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-3086
Country : US
Telephone Number : 240-439-8812
Fax Number : 240-439-8910
Provider Business Practice Location Address
First Line : 1562 OPOSSUMTOWN PIKE
Second Line :
City : FREDERICK
State : MD
Zip : 21702-4920
Country : US
Telephone Number : 240-566-3031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 01/17/2023

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