Provider Demographics
NPI:1639514995
Name:KANTHULA, RUTH M (MD, MPH)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:M
Last Name:KANTHULA
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 LIVINGSTON RD STE 320
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4966
Mailing Address - Country:US
Mailing Address - Phone:443-288-1288
Mailing Address - Fax:
Practice Address - Street 1:9400 LIVINGSTON RD STE 320
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4966
Practice Address - Country:US
Practice Address - Phone:443-288-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD045136208000000X
MDD00834542080P0208X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases