Provider Demographics
NPI:1063848372
Name:VATTI T ANTHONY MD PC
Entity Type:Organization
Organization Name:VATTI T ANTHONY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:VATTI
Authorized Official - Middle Name:T
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-916-1119
Mailing Address - Street 1:4 EXECUTIVE PARK CT
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2645
Mailing Address - Country:US
Mailing Address - Phone:301-916-1119
Mailing Address - Fax:301-540-2682
Practice Address - Street 1:4 EXECUTIVE PARK CT
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2645
Practice Address - Country:US
Practice Address - Phone:301-916-1119
Practice Address - Fax:301-540-2682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty