Provider Demographics
NPI:1942214929
Name:PABLA, RITA (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:
Last Name:PABLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7350 VAN DUSEN RD
Mailing Address - Street 2:STE 130
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5267
Mailing Address - Country:US
Mailing Address - Phone:301-560-4747
Mailing Address - Fax:301-776-1725
Practice Address - Street 1:7350 VAN DUSEN RD
Practice Address - Street 2:SUITE 130
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5263
Practice Address - Country:US
Practice Address - Phone:301-560-4747
Practice Address - Fax:301-776-1725
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0047707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD368131900Medicaid
MDG07479Medicare UPIN
MD00A756R48Medicare ID - Type Unspecified