Provider Demographics
NPI:1346551827
Name:CHITTIREDDY, MADHAVI (RPH)
Entity Type:Individual
Prefix:
First Name:MADHAVI
Middle Name:
Last Name:CHITTIREDDY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CANOGA PL
Mailing Address - Street 2:APT# 1B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-3252
Mailing Address - Country:US
Mailing Address - Phone:443-824-8289
Mailing Address - Fax:
Practice Address - Street 1:300 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1211
Practice Address - Country:US
Practice Address - Phone:410-539-2532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16973183500000X
CA63886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist