Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D0014234 | MD |
NPI | 1134268618 |
---|---|
Provider Name | Dr. Laura Rao Katta |
First Address | Baltimore, MD 21205-2020 |
Second Address | Baltimore, MD 21205-2020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 13/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4737LS | BLUE CROSS BLUE SHIELD MD (01) | MD |
977931100 | (05) | MD |
D76513 | (02) | MD |