Provider Demographics
NPI:1053594895
Name:KULATHUNGAM, MANORANJITHAM (MD)
Entity type:Individual
Prefix:
First Name:MANORANJITHAM
Middle Name:
Last Name:KULATHUNGAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8020 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3710
Mailing Address - Country:US
Mailing Address - Phone:410-668-3000
Mailing Address - Fax:
Practice Address - Street 1:8020 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-3710
Practice Address - Country:US
Practice Address - Phone:410-668-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-16
Last Update Date:2007-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020188208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0078106Medicare UPIN