Provider Demographics
NPI:1508958950
Name:MAHALATI, KATHY (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:
Last Name:MAHALATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15752 CHERRY BLOSSOM LANE
Mailing Address - Street 2:
Mailing Address - City:GALTHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878
Mailing Address - Country:US
Mailing Address - Phone:410-913-2507
Mailing Address - Fax:410-669-6067
Practice Address - Street 1:3331 TOLEDOTERRACE STE 205
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782
Practice Address - Country:US
Practice Address - Phone:301-853-2533
Practice Address - Fax:410-669-6067
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054561207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1M41KOtherBLUE CROSS
MDF895001OtherBLUE CHOICE
MDF895001OtherBLUE CHOICE
MD1M41KOtherBLUE CROSS