Provider Demographics
NPI:1710121694
Name:VENKATARAMANI, MAYA SUBBALAKSHMI (MD, MPH)
Entity Type:Individual
Prefix:MISS
First Name:MAYA
Middle Name:SUBBALAKSHMI
Last Name:VENKATARAMANI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 E MONUMENT ST
Mailing Address - Street 2:SUITE 2-300D
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0007
Mailing Address - Country:US
Mailing Address - Phone:518-859-9718
Mailing Address - Fax:
Practice Address - Street 1:2024 E MONUMENT ST
Practice Address - Street 2:SUITE 2-300D
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0007
Practice Address - Country:US
Practice Address - Phone:518-859-9718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0077322207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208000000XAllopathic & Osteopathic PhysiciansPediatrics