Provider Demographics
NPI:1497935548
Name:MAHINDRANAUTH DEONARINE MD PC
Entity Type:Organization
Organization Name:MAHINDRANAUTH DEONARINE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAHINDRANAUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEONARINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:301-459-6655
Mailing Address - Street 1:9470 ANNAPOLIS RD
Mailing Address - Street 2:SUIT 308
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3025
Mailing Address - Country:US
Mailing Address - Phone:301-459-6655
Mailing Address - Fax:301-459-6695
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:SUIT 308
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:301-459-6655
Practice Address - Fax:301-459-6695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00549262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00825Medicare PIN