Provider Demographics
NPI:1851609747
Name:ASHOK K. CHATTERJEE, MD/PA
Entity Type:Organization
Organization Name:ASHOK K. CHATTERJEE, MD/PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PA
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:K
Authorized Official - Last Name:CHATTERJEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD/PA
Authorized Official - Phone:410-636-3326
Mailing Address - Street 1:3927 ANNAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2229
Mailing Address - Country:US
Mailing Address - Phone:410-636-3326
Mailing Address - Fax:410-636-5954
Practice Address - Street 1:3927 ANNAPOLIS ROAD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-2229
Practice Address - Country:US
Practice Address - Phone:410-636-3326
Practice Address - Fax:410-636-5954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD23530207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD976461500Medicaid
MDE2830001OtherBLUE CROSS
MDE00525Medicare UPIN