Provider Demographics
NPI:1093742371
Name:LALA, PADMA M (MD)
Entity Type:Individual
Prefix:DR
First Name:PADMA
Middle Name:M
Last Name:LALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1410 CRAIN HWY N
Mailing Address - Street 2:STE 3A
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-9303
Mailing Address - Country:US
Mailing Address - Phone:410-766-7800
Mailing Address - Fax:410-766-7855
Practice Address - Street 1:1410 CRAIN HWY N
Practice Address - Street 2:STE 3A
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-9303
Practice Address - Country:US
Practice Address - Phone:410-766-7800
Practice Address - Fax:410-766-7855
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0021027208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU73911Medicare UPIN