Provider Demographics
NPI:1851497861
Name:MENDHIRATTA, ANURITA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANURITA
Middle Name:
Last Name:MENDHIRATTA
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 1:9043 SHADY GROVE CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1301
Mailing Address - Country:US
Mailing Address - Phone:301-987-7250
Mailing Address - Fax:301-987-0199
Practice Address - Street 1:9043 SHADY GROVE CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1301
Practice Address - Country:US
Practice Address - Phone:301-987-7250
Practice Address - Fax:301-987-0199
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD38262207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD141911100Medicaid
MD141911100Medicaid
MDG02670A01Medicare PIN