Provider Demographics
NPI:1073767323
Name:DEVATHI, SUDHAKAR VENKATA LAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:SUDHAKAR
Middle Name:VENKATA LAKSHMI
Last Name:DEVATHI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6934 AVIATION BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-2593
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:443-949-0825
Practice Address - Street 1:6934 AVIATION BLVD STE B
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-2593
Practice Address - Country:US
Practice Address - Phone:443-949-0814
Practice Address - Fax:443-949-0825
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD72957207R00000X, 207RI0200X
DCMD040391207R00000X
TXQ1813207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease