Provider Demographics
NPI:1871513671
Name:NAGANNA, HEMALATHA (MD)
Entity type:Individual
Prefix:DR
First Name:HEMALATHA
Middle Name:
Last Name:NAGANNA
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 1:700A POOLE RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-7229
Mailing Address - Country:US
Mailing Address - Phone:410-848-5250
Mailing Address - Fax:410-848-5375
Practice Address - Street 1:700A POOLE RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7229
Practice Address - Country:US
Practice Address - Phone:410-848-5250
Practice Address - Fax:410-848-5375
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061755207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD190LL462OtherMEDICARE LEGACY NUMBER
MD190LL462OtherMEDICARE LEGACY NUMBER
190LL462Medicare PIN
190LL462Medicare Oscar/Certification