Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | D0072029 | MD |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D0072029 | MD |
NPI | 1316127319 |
---|---|
Provider Name | Dr. Raj Yalamanchili |
First Address | Bel Air, MD 21014-4328 |
Second Address | Bel Air, MD 21014-4328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2007 |
Last Update Date | 10/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043958400 | (05) | MD |