Provider Demographics
NPI:1871182873
Name:CHITKULA, MANJULA (RPH)
Entity Type:Individual
Prefix:
First Name:MANJULA
Middle Name:
Last Name:CHITKULA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8104 WINDING ROSS WAY
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-5529
Mailing Address - Country:US
Mailing Address - Phone:479-426-0978
Mailing Address - Fax:
Practice Address - Street 1:1841 COLUMBIA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2059
Practice Address - Country:US
Practice Address - Phone:202-795-9711
Practice Address - Fax:202-897-2250
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100001270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist