Provider Demographics
NPI:1558354860
Name:VENKATRAMAN, CHITRA (MD)
Entity Type:Individual
Prefix:
First Name:CHITRA
Middle Name:
Last Name:VENKATRAMAN
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 1:10710 RIVER RD
Mailing Address - Street 2:CHITRA VENKATRAMAN, M.D., P.A.
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4114
Mailing Address - Country:US
Mailing Address - Phone:301-345-1800
Mailing Address - Fax:301-345-3854
Practice Address - Street 1:7300 HANOVER DRIVE
Practice Address - Street 2:SUITE 301
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-345-1800
Practice Address - Fax:301-345-3854
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD41715174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
522208885OtherTAX ID
1558354860OtherNPI
MDD41715OtherLICENSE
MD697251900Medicaid
522208885OtherTAX ID
MDD41715OtherLICENSE