Provider Demographics
NPI:1346261278
Name:UNNI, MOORKATH S (MD)
Entity Type:Individual
Prefix:
First Name:MOORKATH
Middle Name:S
Last Name:UNNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:703 NICHOLAS LANE
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030
Mailing Address - Country:US
Mailing Address - Phone:410-803-2211
Mailing Address - Fax:410-420-9841
Practice Address - Street 1:602 S ATWOOD RD
Practice Address - Street 2:SUITE 106
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014
Practice Address - Country:US
Practice Address - Phone:410-803-2211
Practice Address - Fax:410-420-9841
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0051090207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD213100500Medicaid
G40727Medicare UPIN
MD213100500Medicaid