Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | D86087 | MD |
NPI | 1215092036 |
---|---|
Provider Name | Dr. Shelby Kutty |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 19/09/2018 |