Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | D0079068 | MD |
NPI | 1013208461 |
---|---|
Provider Name | Charmian D Sittambalam |
First Address | Baltimore, MD 21237-3901 |
Second Address | Baltimore, MD 21237-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2011 |
Last Update Date | 09/09/2015 |