Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D0061416 | MD |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | D0061416 | MD |
N | 207XX0801X | Orthopaedic Trauma Surgeon | D0061416 | MD |
NPI | 1053400366 |
---|---|
Provider Name | Dr. Sridhar Durbhakula |
First Address | Bethesda, MD 20817-1106 |
Second Address | Bethesda, MD 20817-1106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 15/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3124783 | ALLIANCE/MAMSI (01) | |
3124783 | MDIPA/OPCHOICE (01) | |
37520016 | BLUE CROSS OF NATL CAP AR (01) | |
4170527 | CIGNA (01) | |
64138603 | CAREFIRST BLUE CROSS (01) | |
686082 | NCPPO (01) | |
894071 | PTAN NUMBER (01) | MD |
H22890 | (02) |