Provider Demographics
NPI:1336160290
Name:NATESAN, USHA (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:
Last Name:NATESAN
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 1:951 MOUNT HERMON RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5159
Mailing Address - Country:US
Mailing Address - Phone:410-749-4400
Mailing Address - Fax:410-219-3485
Practice Address - Street 1:951 MOUNT HERMON RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5159
Practice Address - Country:US
Practice Address - Phone:410-749-4400
Practice Address - Fax:410-219-3485
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD767504600Medicaid
MDG58634Medicare UPIN
MD003MMedicare ID - Type Unspecified