Mukta Medical INC
NPI #1194197152 in Randallstown, Maryland
Provider Information
- NPI Number
- 1194197152
- Entity Type
- Organization
- Organization Name
- Mukta Medical INC
- Primary Specialty
- Internal Medicine - Infectious Disease
- Enumeration Date
- Oct 29, 2015
- Last Updated
- Sep 14, 2016
Practice Location
- Address
- 5415 OLD COURT RD
- Address 2
- SUITE 101
- City
- Randallstown
- State
- Maryland
- ZIP Code
- 21133-5170
- Phone
- (410) 922-2650
Authorized Official
- Name
- MOHAMMED KIDDUGAVU, M.D.
- Title
- OWNER
- Phone
- (410) 922-2650
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Infectious Disease — Infectious Disease |
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