Provider Demographics
NPI:1588839526
Name:DIDOLKAR, MANJIRI MUKUND (MD, MS)
Entity Type:Individual
Prefix:
First Name:MANJIRI
Middle Name:MUKUND
Last Name:DIDOLKAR
Suffix:
Gender:F
Credentials:MD, MS
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Mailing Address - Street 1:7253 AMBASSADOR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2710
Mailing Address - Country:US
Mailing Address - Phone:443-436-1116
Mailing Address - Fax:443-436-1256
Practice Address - Street 1:7253 AMBASSADOR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-2710
Practice Address - Country:US
Practice Address - Phone:443-436-1116
Practice Address - Fax:443-436-1256
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2428112085R0202X
NC2009-009272085R0202X
MDD00757852085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology